The Penn Classification Predicts Hospital Mortality in Acute Stanford Type A and Type B Aortic Dissections.
The Penn Classification Predicts Hospital Mortality in Acute Stanford Type A and Type B Aortic Dissections.
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DOI：
10.1053/j.jvca.2019.08.036
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发表时间：
2020-04
影响因子：
2.8
通讯作者：
Cheung AT
中科院分区：
文献类型：
--
作者：
Tien M;Ku A;Martinez-Acero N;Zvara J;Sun EC;Cheung AT
急性主动脉夹层的死亡率因解剖位置、范围和相关并发症而异。斯坦福分类指导手术与药物治疗。 Penn 分类对接受手术的斯坦福 A 型主动脉夹层患者的死亡风险进行了分层。我们的目的是确定 Penn 分类是否可以预测接受手术或药物治疗的急性斯坦福 A 型和 B 型主动脉夹层的医院死亡率。回顾性、观察性研究 三级护理、大学医院 2008 年 1 月至 2017 年 12 月期间患有急性主动脉夹层的患者 手术或药物治疗后的医院死亡率检查 352 名患者确诊有夹层（186 例 A 型，166 例 B 型）。 A 型的总死亡率为 18.8%，B 型的总死亡率为 13.3%。接受手术修复的 A 型或 B 型夹层的 Penn A 级患者死亡率最低（均为 3.1%）。接受医疗治疗的 Penn b、c 或 b+c 级 A 型患者和 Penn b+c 级 B 型夹层患者的死亡率最高（50.0-57.1%）。所有其他人的死亡率均为中等（6.7-39.3%）。 Logistic 回归分析表明，Penn b、c 和 b+c 级患者的死亡率和预测死亡率高于 Penn A 级患者。 Penn 分类可预测接受手术或药物治疗的急性斯坦福 A 型或 B 型主动脉夹层患者的医院死亡率。对于无缺血表现的 B 型夹层患者，早期血管内修复可能会降低死亡风险。
Mortality in acute aortic dissection varies depending on anatomic location, extent, and associated complications. The Stanford classification guides surgical versus medical management. The Penn classification stratifies mortality risk in patients with Stanford type A aortic dissections undergoing surgery. Our objective was to determine if the Penn classification can predict hospital mortality in acute Stanford type A and type B aortic dissections undergoing surgical or medical management. Retrospective, observational study Tertiary-care, university hospital Patients with acute aortic dissection between January 2008 and December 2017 Examination of hospital mortality following surgical or medical management 352 patients had confirmed dissections (186 type A, 166 type B). The overall mortality was 18.8% for type A and 13.3% for type B. Penn class a patients with type A or type B dissections undergoing surgical repair had the lowest mortality (both 3.1%). Penn class b, c, or b+c patients with type A and Penn class b+c patients with type B dissections undergoing medical management had the highest mortality (50.0-57.1%). All others had intermediate mortality (6.7-39.3%). Logistic regression analysis demonstrated that Penn class b, c, and b+c patients had higher odds of mortality and predicted mortality than Penn class a patients. The Penn classification predicts hospital mortality in patients with acute Stanford type A or type B aortic dissections undergoing surgical or medical management. Early endovascular repair may confer lower risk of mortality in patients with type B dissections presenting without ischemia.
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影响因子：
2.8
作者：
Kimura, Naoyuki;Ohnuma, Tetsu;Adachi, Hideo
通讯作者：
Adachi, Hideo
DOI：
10.1038/ncpcardio1417
发表时间：
2009-02-01
期刊：
NATURE CLINICAL PRACTICE CARDIOVASCULAR MEDICINE
影响因子：
--
作者：
Augoustides, John G. T.;Geirsson, Arnar;Bavaria, Joseph E.
通讯作者：
Bavaria, Joseph E.
影响因子：
4.6
作者：
Olsson, Christian;Hillebrant, Carl-Gustaf;Franco-Cereceda, Anders
通讯作者：
Franco-Cereceda, Anders
影响因子：
120.7
作者：
Hagan, PG;Nienaber, CA;Eagle, KA
通讯作者：
Eagle, KA
影响因子：
4.6
作者：
Rampoldi, Vincenzo;Trimarchi, Santi;Isselbacher, Eric M.
通讯作者：
Isselbacher, Eric M.