Details

Autor(en) / Beteiligte

• Marume, Kyohei
• Noguchi, Teruo
• Kaichi, Ryota
• Yano, Takao
• Matsuyama, Masakazu
• Nagamine, Yasuhiro
• Mori, Takayuki
• Mikami, Takafumi
• Ikebe, Sou
• Takae, Masafumi
• Komaki, Soichi
• Ishii, Masanobu
• Toida, Reiko
• Kurogi, Kazumasa
• Inoue, Yosuke
• Matsuda, Hitoshi
• Murata, Shunsuke
• Nakaoku, Yuriko
• Ogata, Soshiro
• Nishimura, Kunihiro
• Nakashima, Takahiro
• Yamaguchi, Tetsuro
• Yamamoto, Nobuyasu
• Tsujita, Kenichi

Titel

Women With Acute Aortic Dissection Have Higher Prehospital Mortality Than Men

Ist Teil von

• JACC. Advances (Online), 2023-10, Vol.2 (8), p.100623, Article 100623

Ort / Verlag

Elsevier

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Acute aortic dissection (AAD) often leads to out-of-hospital cardiac arrest (OHCA) and death before hospital arrival.BackgroundAcute aortic dissection (AAD) often leads to out-of-hospital cardiac arrest (OHCA) and death before hospital arrival.The purpose of this study was to investigate differences in AAD incidence by sex.ObjectivesThe purpose of this study was to investigate differences in AAD incidence by sex.A population-based study in a city with 121,180 residents was conducted using postmortem computed tomography data to identify patients with AAD who died before hospital arrival in 2008-2020. The incidence rate ratio and odds ratio were estimated using Poisson regression and univariable logistic regression, respectively.MethodsA population-based study in a city with 121,180 residents was conducted using postmortem computed tomography data to identify patients with AAD who died before hospital arrival in 2008-2020. The incidence rate ratio and odds ratio were estimated using Poisson regression and univariable logistic regression, respectively.A total of 266 patients with incident AAD were enrolled: 84 patients with OHCA, 137 women [n = 137], and 164 patients with type A AAD. The crude and age-adjusted incidence of AAD was 16.2 and 14.3/100,000 person-years, respectively. The incidence of AAD was comparable by sex (men, 16.7/100,000 person-years; women, 15.7/100,000 person-years; incidence rate ratio: 0.94; 95% CI: 0.74-1.20; P = 0.64). Compared with men with AAD, women with AAD were older (77 ± 11 years vs 70 ± 14 years; P < 0.001), and a higher proportion had type A AAD (76% vs 47%; P < 0.001). Women with AAD had higher prehospital mortality than men with AAD (37% vs 21%; P = 0.004; OR: 2.24; 95% CI: 1.30-3.87; P = 0.004). Among 1,373 patients with OHCA, the proportion of women with AAD was significantly higher than the proportion of men with AAD (11% vs 3.9%; P < 0.001; OR: 2.90; 95% CI: 1.86-4.53; P < 0.001). AAD was most common in women aged 60 to 69 years (16.4%).ResultsA total of 266 patients with incident AAD were enrolled: 84 patients with OHCA, 137 women [n = 137], and 164 patients with type A AAD. The crude and age-adjusted incidence of AAD was 16.2 and 14.3/100,000 person-years, respectively. The incidence of AAD was comparable by sex (men, 16.7/100,000 person-years; women, 15.7/100,000 person-years; incidence rate ratio: 0.94; 95% CI: 0.74-1.20; P = 0.64). Compared with men with AAD, women with AAD were older (77 ± 11 years vs 70 ± 14 years; P < 0.001), and a higher proportion had type A AAD (76% vs 47%; P < 0.001). Women with AAD had higher prehospital mortality than men with AAD (37% vs 21%; P = 0.004; OR: 2.24; 95% CI: 1.30-3.87; P = 0.004). Among 1,373 patients with OHCA, the proportion of women with AAD was significantly higher than the proportion of men with AAD (11% vs 3.9%; P < 0.001; OR: 2.90; 95% CI: 1.86-4.53; P < 0.001). AAD was most common in women aged 60 to 69 years (16.4%).Women had a higher incidence of AAD presenting as prehospital death than men.ConclusionsWomen had a higher incidence of AAD presenting as prehospital death than men.