Journal Article

Preoperative clinical characteristics and risk assessment in Sun’s modified classification of Stanford type A acute aortic dissection

Yang, Bo, Sun, Lizhong, Zhou, Chenyang, Yao, Jian, Bai, Tao

2024

Overview

Objectives This study aims to retrospectively analyze the clinical features of Stanford type A acute aortic dissection (TAAAD) based on Sun’s modified classification, and to investigate whether the Sun’s modified classification can be used to assess the risk of preoperative rupture. Methods Clinical data was collected between January 2018 and June 2019. Data included patient demographics, history of disease, type of dissection according to the Sun’s modified classification, time of onset, biochemical tests, and preoperative rupture. Results A total of 387 patients with TAAAD who met the inclusion criteria of Sun’s modified classification were included. There were more complex types, with 75, 151 and 140 patients in the type A1C, A2C and A3C groups, respectively. The age of the entire group of patients was 51.46 ± 12.65 years and 283 (73.1%) were male. The time from onset to the emergency room was 25.37 ± 30.78 h. There were a few cases of TAAAD combined with stroke, pericardial effusion, pleural effusion, and lower extremity and organ ischemia in the complex type group. The white blood cell count (WBC), neutrophil count (NEC) and blood amylase differed significantly between the groups. Three independent risk factors for preoperative rupture were identified: neutrophil count, blood potassium ion level, and platelet count. Binary logistic regression analysis showed that the Sun’s modified classification could not be used to assess the risk of preoperative rupture in TAAAD. Conclusion TAAAD was classified as the complex type in most patients. WBC, NEC and blood amylase were significantly different between the groups. NEC and serum potassium ion level were independent risk factors for preoperative rupture of TAAAD, while platelet count was its protective factor. More samples are needed to determine whether Sun’s modified classification can be used to evaluate the risk of preoperative rupture.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acute aortic dissection / Acute Disease / Adult / Aged / Aneurysms / Angiology / Aortic Aneurysm - blood / Aortic Aneurysm - classification / Aortic Aneurysm - diagnostic imaging / Aortic Aneurysm - epidemiology / Aortic Aneurysm - surgery / Aortic dissection / Aortic Dissection - blood / Aortic Dissection - classification / Aortic Dissection - diagnostic imaging / Aortic Dissection - epidemiology / Aortic Dissection - surgery / Aortic rupture / Aortic Rupture - blood / Aortic Rupture - classification / Aortic Rupture - diagnostic imaging / Aortic Rupture - etiology / Aortic Rupture - surgery / Blood levels / Blood tests / Blood Transfusion Medicine / Cardiac Surgery / Cardiology / Cardiovascular disease / Care and treatment / Classification / Coronary vessels / Diabetes / Dissecting aneurysm / Dissection / Emergency medical care / Female / Heart surgery / Hospitals / Humans / Hypertension / Identification and classification / Internal Medicine / Ischemia / Leukocyte Count / Leukocytes (neutrophilic) / Male / Marfan syndrome / Medicine / Medicine & Public Health / Methods / Middle Aged / Modified classification / Patients / Platelets / Pleural effusion / Predictive Value of Tests / Preoperative care / Prognosis / Regression analysis / Retrospective Studies / Risk Assessment / Risk factor / Risk Factors / Rupture / Stanford type A