Suzuki et al identified risk factors for in-hospital mortality for a patient with acute type B aortic dissection. These can help to identify a patient who may require more aggressive management. The authors are from multiple institutions from around the world and used the International Registry of Aortic Dissection (IRAD).
In-hospital mortality: 13%
Deadly triad:
(1) hypotension or shock (OR 23.8)
(2) absence of chest or back pain on presentation (OR 3.5)
(3) branch vessel involvement with malperfusion (OR 2.9)
Other risk factors used in prediction model:
(4) age >= 70 years (OR 1.6, p = 0.3))
(5) male gender (OR 0.96, p = 0.92)
Additional factors identified on univariate analysis:
(1) widened mediastinum
(2) periaortic hematoma
(3) dilated aorta >= 6 cm
(4) coma or altered consciousness
(5) having surgical management (vs medical)
