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Clinical Features of 544 Patients With Ruptured Aortic Aneurysm - A Report From the Tokyo Acute Aortic Super Network Database.

Authors :
Akutsu K
Yoshino H
Shimokawa T
Ogino H
Kunihara T
Takahashi T
Usui M
Watanabe K
Yamasaki M
Fujii T
Kawata M
Watanabe Y
Yamamoto T
Kohsaka S
Nagao K
Takayama M
Source :
Circulation journal : official journal of the Japanese Circulation Society [Circ J] 2024 Sep 25; Vol. 88 (10), pp. 1664-1671. Date of Electronic Publication: 2024 Feb 28.
Publication Year :
2024

Abstract

Background: Epidemiological data on ruptured aortic aneurysms from large-scale studies are scarce. The aims of this study were to: clarify the clinical course of ruptured aortic aneurysms; identify aneurysm site-specific therapies and outcomes; and determine the clinical course of patients receiving conservative therapy.<br />Methods and Results: Using the Tokyo Acute Aortic Super Network database, we retrospectively analyzed 544 patients (mean [±SD] age 78±10 years; 70% male) with ruptured non-dissecting aortic aneurysms (AAs) after excluding those with impending rupture. Patient characteristics, status on admission, therapeutic strategy, and outcomes were evaluated. Shock or pulselessness on admission were observed in 45% of all patients. Conservative therapy, endovascular therapy (EVT), and open surgery (OS) accounted for 32%, 23%, and 42% of cases, respectively, with corresponding mortality rates of 93%, 30%, and 29%. The overall in-hospital mortality rate was 50%. The prevalence of pulselessness was highest (48%) in the ruptured ascending AA group, and in-hospital mortality was the highest (70%) in the ruptured thoracoabdominal AA group. Multivariable logistic regression analysis indicated in-hospital mortality was positively associated with pulselessness (odds ratio [OR] 10.12; 95% confidence interval [CI] 4.09-25.07), and negatively associated with invasive therapy (EVT and OS; OR 0.11; 95% CI 0.06-0.20).<br />Conclusions: The outcomes of ruptured AAs remain poor; emergency invasive therapy is essential to save lives, although it remains challenging to reduce the risk of death.

Details

Language :
English
ISSN :
1347-4820
Volume :
88
Issue :
10
Database :
MEDLINE
Journal :
Circulation journal : official journal of the Japanese Circulation Society
Publication Type :
Academic Journal
Accession number :
38417888
Full Text :
https://doi.org/10.1253/circj.CJ-23-0636