Abstract 12912: The First Report from Japanese Registration of Acute Aortic Dissection
Background: This decade, a lot of informative articles have been published from the International Registration of Acute Aortic Dissection (IRAD) enrolling patients of the western countries, which have clarified the clinical presentations, managements including endografting, and outcomes of acute aortic dissection. However, little has been demonstrated on Japanese patients, although reportedly the incidence of aortic dissection is higher. In 2011, the Japanese Registration of Acute Aortic Dissection (JRAD) consisting of 19 referral centers of the all areas in Japan was started on the model of the IRAD. The data were analyzed as the first report to assess the clinical presentations, managements, and outcomes of acute aortic dissection in Japan.
Methods: Between 2011 and 2013, a total of 858 patients suffered from acute aortic dissection were enrolled into the JRAD. The data of 607 patients (age 66.9±13.5 years, 52% male) were investigated for this first report. Of them, 69.0% had type A aortic dissection and 3.3% connective tissue disorders. The presentations at the admission were shock in 16.2%, cardiac tamponade in 21.3%, loss of consciousness in 4.8%, heart failure in 4.8%, and limb ischemia in 13.5%. The false lumen was patent in 70.1% and thrombosed in 29.8%. In the type-A aortic dissection, 87.6% of the patients were treated surgically (including the endovascular treatment), while 78.7% medically in the type-B aortic dissection.
Results: The in-hospital mortality rate was 12.5% in the type-A aortic dissection: 14.1% surgically and 37.5% medically. In the type-B aortic dissection, it was 6.4%: 6.8% medically and 20.0% surgically. The hospital admission was 19.0 days in the type-A and 24.2 days in the type-B aortic dissection.
CONCLUSION: Compared with the IRAD data, the outcomes were generally better in the JRAD, in particular, of the patients undergoing the surgical treatment for type-A aortic dissection. There might be some differences in the clinical presentations at the onset, diagnosis, and managements including the patient transfer between the IRAD and the JRAD.
- © 2013 by American Heart Association, Inc.