Women Present With More Advanced Acute Aortic Dissection

After adjustment, female sex trended toward higher in-hospital mortality overall, but not in the last decade of enrollment

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MONDAY, June 14, 2021 (HealthDay News) -- Women with acute aortic dissection are older and have more advanced disease at presentation than men, according to a study published online June 1 in The Annals of Thoracic Surgery.

Lauren V. Huckaby, M.D., from the University of Pittsburgh Medical Center, and colleagues queried the Interventional Cohort of the International Registry of Acute Aortic Dissection database to examine sex differences in presentation, operative approach, and outcomes.

The researchers found that women comprised 34.3 percent of the 2,823 patients and were significantly older than men (mean age, 65.4 versus 58.6 years). Women more often had hypotension or coma and were more likely to present with intramural hematoma, periaortic hematoma, or complete or partial false lumen thrombosis. The proportion of Bentall, complete arch, and elephant trunk procedures was greater among men. During the study period, in-hospital mortality was significantly higher in women (16.7 versus 13.8 percent; P = 0.039). Female sex trended toward higher in-hospital mortality overall (odds ratio, 1.40; 95 percent confidence interval, 1.00 to 1.98; P = 0.053) after adjustment, but not in the last decade of enrollment (odds ratio, 0.93; 95 percent confidence interval, 0.54 to 1.62; P = 0.807). There were no significant differences noted between the sexes in five-year mortality and reintervention rates.

"This study underscores the need for further interrogatories into these sex differences that may help provoke refined sex-directed strategies to further improve outcomes," a coauthor said in a statement.

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