The aim of this study was to identify the most important variables associated with early and late mortality in @entity1 operated on for @entity1580 over a 15-year period. From January 1984 to March 1999, 110 @entity1 underwent surgery for @entity1580 . The 88.1% of @entity1 had an acute type @entity1129 ( @entity1129 ) and 11.8% had a @entity102 ( @entity102 ). @entity2293 occurred in 21.8% and 14.5% of the @entity1 , respectively. The location of the primary intimal tear was in the ascending aorta in 70.9% of cases, in the arch in 17.2%, and in the descending aorta in 7.2%. Univariate and multivariate analyses were conducted to identify non-embolic variables independently correlated to in-hospital death. Kaplan-Meier and Cox regression analyses and hazard function for death risk were used to analyze factors influencing overall and surgical survival. The overall in-hospital mortality rate was 20.9% (23/110 @entity1 ), being 9% for @entity102 and 21.6% for @entity1129 . Emergent procedures had an in-hospital mortality rate of 47.6%, whereas nonemergent operations had an in-hospital mortality rate of 13.7% (p < 0.01). Univariate analysis revealed 41 preoperative and operative variables, including age (years), age >70 years, remote @entity583 , @entity409 , @entity6 , preoperative @entity177 , shock, cardiopulmonary bypass time (minutes), emergency operation, as factors associated to in-hospital death (p < 0.05). Stepwise logistic regression analysis for in-hospital death selected as independent predicting variables (p < 0.05) remote @entity583 [p = 0.006, odds ratio (OR) = 1.9], preoperative @entity177 (p = 0.031; OR = 0.8), shock (p = 0.001; OR = 3.1), and age >70 years (p = 0.007; OR = 1.7). Follow-up ranged from 9 to 172 months (median 78 months), with Kaplan-Meier survivals for all the @entity1 and hospital survivors of 42% and 54% at 10 years, respectively. Cox regression analysis has identified @entity64 [relative risk (RR) = 3.7; p = 0.012), intimal tear in the aortic arch (RR = 2.3; p = 0.036), and @entity177 (RR = 4.5; p = 0.007) as independent predictors of reduced survival at follow-up. When this kind of analysis was performed on hospital survivors only, preoperative @entity8 (RR = 1; p = 0.013), reoperation (RR = 1.7;p = 0.004) and intimal tear in the aortic arch (RR = 1.2; p = 0.002) emerged as risk factors. The actuarial freedom from reoperation was 85.4% at 5 years. Multiple factors still influence early and late survival after surgery for @entity1580 . Preoperative @entity8 both affects early and late outcome. Early postoperative course affects late outcome in hospital survivors. The presence of the intimal tear in the aortic arch has a negative impact on late survival.

Determinants of early and late outcome after surgery for XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity8 :: ('MESH:D007674', 'Disease') :: ['renal impairment', 'renal dysfunction'] @entity64 :: ('MESH:D020521', 'Disease') :: ['postoperative stroke'] @entity2293 :: ('MESH:D002305', 'Disease') :: ['Cardiac tamponade and shock'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity409 :: ('MESH:D008107', 'Disease') :: ['cerebrovascular dysfunction'] @entity102 :: ('MESH:D002908', 'Disease') :: ['chronic dissection', 'CD'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure', 'postoperative renal failure'] @entity1129 :: ('MESH:D001260', 'Disease') :: ['AD', 'A dissection'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity1580 :: ('MESH:C562834', 'Disease') :: ['type A aortic dissection']
@entity1580 :: (MESH:C562834,Disease) :: ['type A aortic dissection']
