Thrombocytopenia: an early marker of late mortality in type B aortic dissection. Delsart, P., Beregi, J., Devos, P., Haulon, S., Midulla, M., & Mounier-Vehier, C. Heart and vessels, 29(2):220–230, March, 2014. doi abstract bibtex Mid-term and long-term mortality after aortic dissection remain high and due to unknown factors. To determine predicting factors at the acute phase associated with mid- and long-term all-cause mortality, patients with type B aortic dissection including intramural hematoma, treated in one referral university center in an area with a population of 4 million, were analyzed over a period of 12 years (from 1996 to 2008). Based on the total population, 77 patients discharged after type B aortic dissection (including 11 intramural hematoma) were recorded as treated with either medical treatment alone (n = 41) or with additional endovascular therapy (n = 36). The mean follow-up period was 50.8 months, with a survival rate of 78 % (17 deaths). Patient history, symptoms, medical treatment, biological parameters, imaging, and intervention during acute phase (more than 150 parameters) were analyzed to identify any relationship with complications and death. Kaplan-Meier survival curve and Cox proportional hazards analyses identified independent predictors of follow-up mortality from any cause. Factors influencing mortality (P \textless 0.05) were a low systolic blood pressure (SBP) at admission, a thrombocytopenia in the acute period, chronic bronchitis, diameter of ascending aorta, and renin-angiotensin system inhibitor intake. Independent predictors of mortality were chronic bronchitis (P = 0.0022, hazard ratio (HR) 17.5), early thrombocytopenia (P = 0.042, HR 3.5), and admission SBP \textless120 mmHg (P = 0.0048, HR 7.928). Treated (medical +/- endovascular) type B aortic dissection held a worse long-term prognosis, which can be correlated with predicting factors, especially in-hospital thrombocytopenia, and should require closer follow-up.
@article{delsart_thrombocytopenia:_2014,
title = {Thrombocytopenia: an early marker of late mortality in type {B} aortic dissection.},
volume = {29},
issn = {1615-2573 0910-8327},
doi = {10.1007/s00380-013-0354-x},
abstract = {Mid-term and long-term mortality after aortic dissection remain high and due to unknown factors. To determine predicting factors at the acute phase associated with mid- and long-term all-cause mortality, patients with type B aortic dissection including intramural hematoma, treated in one referral university center in an area with a population of 4 million, were analyzed over a period of 12 years (from 1996 to 2008). Based on the total population, 77 patients discharged after type B aortic dissection (including 11 intramural hematoma) were recorded as treated with either medical treatment alone (n = 41) or with additional endovascular therapy (n = 36). The mean follow-up period was 50.8 months, with a survival rate of 78 \% (17 deaths). Patient history, symptoms, medical treatment, biological parameters, imaging, and intervention during acute phase (more than 150 parameters) were analyzed to identify any relationship with complications and death. Kaplan-Meier survival curve and Cox proportional hazards analyses identified independent predictors of follow-up mortality from any cause. Factors influencing mortality (P {\textless} 0.05) were a low systolic blood pressure (SBP) at admission, a thrombocytopenia in the acute period, chronic bronchitis, diameter of ascending aorta, and renin-angiotensin system inhibitor intake. Independent predictors of mortality were chronic bronchitis (P = 0.0022, hazard ratio (HR) 17.5), early thrombocytopenia (P = 0.042, HR 3.5), and admission SBP {\textless}120 mmHg (P = 0.0048, HR 7.928). Treated (medical +/- endovascular) type B aortic dissection held a worse long-term prognosis, which can be correlated with predicting factors, especially in-hospital thrombocytopenia, and should require closer follow-up.},
language = {eng},
number = {2},
journal = {Heart and vessels},
author = {Delsart, Pascal and Beregi, Jean-Paul and Devos, Patrick and Haulon, Stephan and Midulla, Marco and Mounier-Vehier, Claire},
month = mar,
year = {2014},
pmid = {23604315},
keywords = {Humans, Female, Aged, Male, Middle Aged, Treatment Outcome, Chi-Square Distribution, Hospitals, University, Risk Assessment, Risk Factors, France, Time Factors, Blood Pressure, Aneurysm, Dissecting/diagnosis/*mortality/physiopathology/therapy, Aortic Aneurysm/diagnosis/*mortality/physiopathology/therapy, Bronchitis/diagnosis/mortality, Chronic Disease, Endovascular Procedures, Kaplan-Meier Estimate, Proportional Hazards Models, Systole, Thrombocytopenia/diagnosis/*mortality},
pages = {220--230}
}
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Based on the total population, 77 patients discharged after type B aortic dissection (including 11 intramural hematoma) were recorded as treated with either medical treatment alone (n = 41) or with additional endovascular therapy (n = 36). The mean follow-up period was 50.8 months, with a survival rate of 78 % (17 deaths). Patient history, symptoms, medical treatment, biological parameters, imaging, and intervention during acute phase (more than 150 parameters) were analyzed to identify any relationship with complications and death. Kaplan-Meier survival curve and Cox proportional hazards analyses identified independent predictors of follow-up mortality from any cause. Factors influencing mortality (P \\textless 0.05) were a low systolic blood pressure (SBP) at admission, a thrombocytopenia in the acute period, chronic bronchitis, diameter of ascending aorta, and renin-angiotensin system inhibitor intake. Independent predictors of mortality were chronic bronchitis (P = 0.0022, hazard ratio (HR) 17.5), early thrombocytopenia (P = 0.042, HR 3.5), and admission SBP \\textless120 mmHg (P = 0.0048, HR 7.928). Treated (medical +/- endovascular) type B aortic dissection held a worse long-term prognosis, which can be correlated with predicting factors, especially in-hospital thrombocytopenia, and should require closer follow-up.","language":"eng","number":"2","journal":"Heart and vessels","author":[{"propositions":[],"lastnames":["Delsart"],"firstnames":["Pascal"],"suffixes":[]},{"propositions":[],"lastnames":["Beregi"],"firstnames":["Jean-Paul"],"suffixes":[]},{"propositions":[],"lastnames":["Devos"],"firstnames":["Patrick"],"suffixes":[]},{"propositions":[],"lastnames":["Haulon"],"firstnames":["Stephan"],"suffixes":[]},{"propositions":[],"lastnames":["Midulla"],"firstnames":["Marco"],"suffixes":[]},{"propositions":[],"lastnames":["Mounier-Vehier"],"firstnames":["Claire"],"suffixes":[]}],"month":"March","year":"2014","pmid":"23604315","keywords":"Humans, Female, Aged, Male, Middle Aged, Treatment Outcome, Chi-Square Distribution, Hospitals, University, Risk Assessment, Risk Factors, France, Time Factors, Blood Pressure, Aneurysm, Dissecting/diagnosis/*mortality/physiopathology/therapy, Aortic Aneurysm/diagnosis/*mortality/physiopathology/therapy, Bronchitis/diagnosis/mortality, Chronic Disease, Endovascular Procedures, Kaplan-Meier Estimate, Proportional Hazards Models, Systole, Thrombocytopenia/diagnosis/*mortality","pages":"220–230","bibtex":"@article{delsart_thrombocytopenia:_2014,\n\ttitle = {Thrombocytopenia: an early marker of late mortality in type {B} aortic dissection.},\n\tvolume = {29},\n\tissn = {1615-2573 0910-8327},\n\tdoi = {10.1007/s00380-013-0354-x},\n\tabstract = {Mid-term and long-term mortality after aortic dissection remain high and due to unknown factors. To determine predicting factors at the acute phase associated with mid- and long-term all-cause mortality, patients with type B aortic dissection including intramural hematoma, treated in one referral university center in an area with a population of 4 million, were analyzed over a period of 12 years (from 1996 to 2008). Based on the total population, 77 patients discharged after type B aortic dissection (including 11 intramural hematoma) were recorded as treated with either medical treatment alone (n = 41) or with additional endovascular therapy (n = 36). The mean follow-up period was 50.8 months, with a survival rate of 78 \\% (17 deaths). Patient history, symptoms, medical treatment, biological parameters, imaging, and intervention during acute phase (more than 150 parameters) were analyzed to identify any relationship with complications and death. Kaplan-Meier survival curve and Cox proportional hazards analyses identified independent predictors of follow-up mortality from any cause. Factors influencing mortality (P {\\textless} 0.05) were a low systolic blood pressure (SBP) at admission, a thrombocytopenia in the acute period, chronic bronchitis, diameter of ascending aorta, and renin-angiotensin system inhibitor intake. Independent predictors of mortality were chronic bronchitis (P = 0.0022, hazard ratio (HR) 17.5), early thrombocytopenia (P = 0.042, HR 3.5), and admission SBP {\\textless}120 mmHg (P = 0.0048, HR 7.928). 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