[Analysis of death-related factors of type B aortic dissection treated medically during the acute phase].

Objective To analyze the death-related risk factors of type B aortic dissection treated medically during the acute phase (symptoms presenting within 14 d), and to determine the predictors of surgical indications for acute type B aortic dissection. Methods Clinical data of 42 patients with acute type B aortic dissection admitted from January 2007 to May 2009 was retrospectively reviewed. There were 33 male and 9 female with a mean age of (50 ± 12 ) years old. Therapy included analgesia, controlled hypotension and β-receptor blocker, the mortality in acute phase was 33.3% ( 14/42 ). Univariate and multivariate logistic regression analyses were performed to identify the predictors of the death in acute phase. Results In univariate logistic regression analysis, the malperfusion of aortic branches (P= 0. 018 ) and maximum aortic diameter (P = 0. 002) were significant predictors of death. In the multivariate logistic regression model, the malperfusion of aortic branches ( P = 0. 041 ) and maximum aortic diameter ( P= 0. 005 ) were also considered as the significant death-related factors. Risk of death augmented significantly ( P= 0. 000) when the maximum aortic diameter over 40 mm. Conclusion Malperfusion of aortic branches and the large maximum aortic diameter ( >40 mm) are the indications of surgery or endovascular therapy for acute type B aortic dissection. Key words: Aortic aneurysm, thoracic; Emergencies; Drug therapy; Death