Journal Article

Sex-related differences on the risks of in-hospital and late outcomes after acute aortic dissection: A nationwide population-based cohort study

Chen, Fang-Ting, Chen, Shao-Wei, Chu, Pao-Hsien, Cheng, Yu-Ting, Wu, Victor Chien-Chia, Chou, An-Hsun, Chan, Yi‐Hsin, Hung, Kuo-Chun, Lin, Chia-Pin

2022

Overview

The aim of this study is to evaluate the sex-related differences on the risks of perioperative and late outcomes for adult acute aortic dissection (AAD) patients following surgical management. By using Taiwan National Health Insurance Research Database, totally 1,410 female and 3,432 male patients were identified to first-ever receive type A AAD open surgery or type B AAD stenting treatment from 2004 to 2013. We assessed the sex-related difference on outcomes, including in-hospital mortality, all-cause mortality, aortic death, redo aortic surgery, ischemic stroke, and depression during the follow-up period. The analysis was done separately for type A and type B surgeries. On average, female patients diagnosed with AAD were older than males. There was no significant sex difference of in-hospital mortality or all-cause mortality for both type A open and type B stent surgeries. The risk of redo aortic surgery was significantly greater in males than females (7.8% vs. 4%; unadjusted subdistribution hazard ratio [SHR] 0.51, 95% CI 0.38-0.69) for type A open surgery, but not for type B stent surgery. Noticeably, the risk of newly-diagnosed depression was significantly greater in females than males (8% vs. 5.1%; unadjusted SHR 1.6, 95% CI 1.24-2.06) for type A open surgery, but not for type B stent surgery. No significant sex-related difference was found for the in-hospital mortality or accumulative all-cause mortality. However, there were more redo aortic surgeries for males and more postoperative depression for females in type A AAD population.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Aged / Anesthesiology / Aneurysm, Dissecting - mortality / Aneurysm, Dissecting - surgery / Aorta / Aortic Aneurysm - mortality / Aortic Aneurysm - surgery / Aortic dissection / Biology and Life Sciences / Blood transfusions / Cardiology / Care and treatment / Codes / Cohort analysis / Cohort Studies / Demographics / Depression - epidemiology / Depression - etiology / Depression - mortality / Disease / Dissecting aneurysm / Dissection / Epidemiology / Female / Females / Gender differences / Health risks / Heart surgery / Hospital Mortality / Hospitals / Humans / Hypertension / Implants / Ischemia / Ischemic Stroke - epidemiology / Ischemic Stroke - etiology / Ischemic Stroke - mortality / Male / Males / Medicine and Health Sciences / Middle Aged / Mortality / Patient outcomes / Patients / Perioperative Period / Population / Population studies / Population-based studies / Postoperative Complications - epidemiology / Postoperative Complications - mortality / Reimbursement / Reoperation - mortality / Reoperation - statistics & numerical data / Retrospective Studies / Sex / Sex Characteristics / Sex differences / Sexes / Stents / Surgery / Taiwan / Treatment Outcome / Womens health