Acute Aortic Dissection in China

The clinical profiles and outcomes of acute aortic dissection (AAD) have not been evaluated in China. We retrospectively analyzed, from January 1, 2008 to December 31, 2011, the data from 1,812 patients (mean age 51.1 ± 10.9 years; 77.5% men) with AAD (726 with type A and 1,086 with type B) from 19 large hospitals. Most patients had hypertension and presented with an abrupt onset of chest and/or back pain. Patients with type A AAD were more likely to present with typical symptoms and signs. Computed tomography was the most common initial imaging modality, used in 76.3% of patients with an AAD. The overall in-hospital mortality rate was 17.7%, with most of the deaths occurring within the first week. Surgery was used in 75.3% of patients with type A AAD. The mortality in this cohort was 33.8%. Endovascular treatment was performed in 76.1% of patients with type B AAD. The mortality rate was 2.2%. Multivariate analysis showed that hypertension (odds ratio 2.80, p <0.001), Marfan syndrome (odds ratio 1.76, p = 0.017), anterior chest pain (odds ratio 1.62, p = 0.004), abdominal pain (odds ratio 1.51, p = 0.041), migrating pain (odds ratio 1.56, p = 0.04), and arch vessel involvement (odds ratio 1.70, p <0.001) were predictive factors for increased in-hospital mortality in patients with an AAD. In conclusion, our study has provided insight into the current profiles and outcomes of AAD in China. This knowledge might be useful for clinicians when diagnosing and treating these patients.