An Analysis of Perioperative Risk Factors for Long Term Survival after Surgery for Acute Type A Dissection Focusing on Gender-specific Differences

We looked at gender-specific perioperative risk factors for an acute Stanford type A aortic dissection’s survival.

In a 9-year follow-up, 147 patients who had surgery since 2004 were evaluated. The Cox-proportional hazard model was used to analyse the data, which included 36 variables.

After 1 year (5, 10 years), survival was 98 percent (88 percent , 50 percent ). Early mortality was 25% for males and 27% for women, with women dying at a younger age (+10 years, on average) than men. In the seventh decade, the percentage of women was twofold greater, and in the eighth decade, it was thrice higher. For the first postoperative year, the survival probability (Log rank test) was 0.82/0.77 (male/female), 0.70/0.71 for 5 years, and 0.46/ 0.50 for 10 years. In the case of resternotomy (16.543), bleeding (8.1), and renal insufficiency (8.1), women had a significant hazard ratio for mortality (3.4).

Only the EURO-Score (1.103, p=0.038) and hospital stay time (0.849, p=0.015) were found to be significant risk factors for death.

Between 5 and 10 years, the survival curve begins to deteriorate (88 percent to 50 percent ). Age and resternotomy had a substantial impact on survival in male patients. In the seventh and eighth centuries, women had a greater rate of aortic type A dissection. Gender has no bearing on survival.

Author (S) Details

Frank Harig
Department of Cardiac Surgery, University Hospital Erlangen, Friedrich- Alexander University Erlangen, Erlangen, Germany.

Anna Engel
Department of Cardiology and Angiology, University Hospital Erlangen, Friedrich- Alexander University Erlangen, Erlangen, Germany.

Johannes Rösch
Department of Cardiac Surgery, University Hospital Erlangen, Friedrich- Alexander University Erlangen, Erlangen, Germany.

Michael Weyand
Department of Cardiac Surgery, University Hospital Erlangen, Friedrich- Alexander University Erlangen, Erlangen, Germany.

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