Abstract
Objective:In this study we aimed to determine the prediction level of admission diastolic blood pressure (DBP) on the prognosis and mortality in aortic dissection patients over 65 years old and under 65 years old.Methods:We included 72 patients in this retrospective study and study groups were divided into two groups according to 65 age. Demographic data, dissection type (Stanford A-B), DBP, systolic blood pressure (SBP), mean arteriel pressure (MAP), heart rate (/min) main complaints, preoperative length of stay, hospitalisation clinic (clinic/intensive care unit), length of hospitaliisation, complications during hospitalisation (renal failure etc..) and the outcome (death/dischargement) results were noted. Preoperative lenth of stay, hospitalisation length, outcome and complications were compared between groups according to SBP, DBP, MAP and heart rate.Results:Mean blood pressure values of the Stanford type B patients over 65 years old were higher than the other group (p<0.05). Fifty percent of patients under 65 years old were discharged but this ratio was 26.9% in the elder group. DBP was positively correlated with preoperative length of stay and hospitalisation length and negatively correlated with mortality. DBP under 65 mmHg was significantly related with high mortality (p<0.05). When the age and presentation time heart rate is added to each other, the values over 142 were significantly related with high mortality (p<0.05).Conclusions:The presentation time vital signs especially the DBP may be helpful for emergency clinicians to predict the prognosis and outcome in aortic dissection patients which has high mortality ratio in patients over 65 years of age.
Highlights
Aortic dissection (AD), is a cardiovasculary emergency with morbidity and mortality ratios and requires immediately recognition and treatment.[1]
Patient groups were compared for diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arteriel pressure (MAP), heart rate (HR). length of preoperative stay, length of hospitalisation, complication occurence and outcome accoring to age and Stanford classification
Forty-six (63,9%) patients were under 65 years old and 26 (3.1%) patients were over 65 years old. 84,7% of the patients were Stanford type A, 15.3% were Stanford type B
Summary
Aortic dissection (AD), is a cardiovasculary emergency with morbidity and mortality ratios and requires immediately recognition and treatment.[1] Annually 6000-10000 AD patients have been reported in the US. The annual incidence is 2-3.5/100.000.2,3 Mortality per hour for the first two days is 1-3%.4. It is more common in males and incidence increases with age.[5] Uncontrolled hypertension is known as the most common risk factor and 65-75% of the patients are hypertensive.[6] Other risk factors include aortic diseases, aortic valve diseases, aortic family history, cardiovacular surgery history, smoking, Pak J Med Sci March - April 2021 Vol 37 No 2 www.pjms.org.pk 339 pregnancy, connective tissue diseases, direct thorax trauma and iv drug usage.[7]
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