oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Medium-term survival after surgery for acute Type A aortic dissection is improving
Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0002-6913-0669
Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Denmark.
Department of Cardiothoracic Surgery, Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland.
Show others and affiliations
2017 (English)In: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734X, Vol. 52, no 5, p. 852-857Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To report long-term survival and predictors of mortality in patients included in a large, contemporary, multicentre, multinational database: Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD), which consists of 8 centres in 4 Nordic countries.

METHODS: Currently, NORCAAD includes 1159 patients operated between 2005 and 2014. In 30-day survivors (n = 955, 82%), the Kaplan-Meier and Cox proportional hazard methods were used to analyse medium-term (up to 8 years) survival and relative survival versus a matched normal population. Pre- and intraoperative predictors were expressed as hazard ratio (HR) with 95% confidence interval (95% CI).

RESULTS: Cumulative follow-up was 3514 patient-years with a median of 3.2 years (range 0-10.2 years). Survival was 95% (95% CI 93-96) at 1 year, 86% (95% CI 83-88) at 5 years and 76% (95% CI 72-81) at 8 years. Relative survival versus a matched normal population was 95% (95% CI 94-97) at 1 year, 90% (95% CI 87-93) at 5 years and 85% (95% CI 80-90) at 8 years. In multivariable analysis, increased age (HR 1.05 per year, 95% CI 1.04-1.07), previous abdominal or thoracic aortic repair (HR 3.2, 95% CI 1.6-6.4) and chronic renal disease (HR 2.7, 95% CI 1.2-6.2) were associated with increased medium-term mortality. Open distal anastomosis (HR 0.55, 95% CI 0.35-0.87) and operation in the 2010-2014 period (HR 0.90, 95% CI 0.83-0.97) were associated with decreased medium-term mortality.

CONCLUSIONS: Medium-term survival after acute Type A aortic dissection in the NORCAAD registry is satisfactory, close to a matched normal population and improved in the later part of the study period. The use of open distal anastomosis was associated with decreased medium-term mortality.

Place, publisher, year, edition, pages
Oxford University Press, 2017. Vol. 52, no 5, p. 852-857
Keywords [en]
Aortic dissection, NORCAAD, Open distal anastomosis, Outcomes, Survival
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-62455DOI: 10.1093/ejcts/ezx302ISI: 000414364600004PubMedID: 28957999Scopus ID: 2-s2.0-85034078450OAI: oai:DiVA.org:oru-62455DiVA, id: diva2:1162844
Note

Funding agencies:

Mats Kleberg Foundation 

Available from: 2017-12-05 Created: 2017-12-05 Last updated: 2019-03-04Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records BETA

Ahlsson, AndersWickbom, Anders

Search in DiVA

By author/editor
Ahlsson, AndersWickbom, Anders
In the same journal
European Journal of Cardio-Thoracic Surgery
Surgery

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 3 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf