Genoni M Paul M Tavakoli R Künzli A Lachat M Graves K Seifert B Turina M 2002 OBJECTIVES Medical treatment is generally advocated for patients with acute type B aortic dissection without complications. The objective of this retrospective analysis was to determine whether there are any initial findings that can help predict the long-term course of the disease. METHODS Case records of the 130 patients treated for type B aortic dissection between 1988 and 1997 were reviewed; 41 (31%) were operated on in the acute phase (<14 days), 31 (24%) were operated on in the chronic phase and 58 (45%) were treated medically. RESULTS Overall acute mortality was 10.8%; 22% for patients operated on in the early phase and 5.6% for medically treated patients. Age (P=0.002), persistent pain (P=0.01) and malperfusion (P=0.001) were significant independent predictors of the need for surgery. Paraplegia/para paresis (P=0.0001), leg ischaemia (P=0.003), pleural effusion (P=0.003), rupture (P=0.0001), shock (P=0.0001), age (P=0.003), cardiac failure (P=0.002) and aortic diameter >4.5 cm (P=0.002) were significant predictors of poor survival. Age and shock also emerged as independent risk factors. Patients without malperfusion (P=0.0001), pleural effusion (P=0.003), rupture (P=0.0001) and shock (P=0.0001) had a significantly better event-free survival (freedom from repeat surgery and death). The actuarial survival rate for high-risk patients (malperfusion, rupture, shock) was 62% at 1 year and 40% at 5 years; the corresponding values for low-risk patients were 94 and 84%, respectively. CONCLUSIONS Rupture, shock and malperfusion are significant predictors of poor survival in patients with acute type B aortic dissection. application/pdf https://sonar.ch/global/documents/179455 eng info:eu-repo/semantics/altIdentifier/doi/10.1016/s1010-7940(02)00203-8 info:eu-repo/semantics/altIdentifier/pmid/12103374 info:eu-repo/semantics/openAccess European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. - 2002 Adult Aged Aged, 80 and over Aneurysm, Dissecting Aortic Aneurysm Female Hospital Mortality Humans Male Middle Aged Retrospective Studies Risk Factors Survival Analysis Predictors of complications in acute type B aortic dissection. http://purl.org/coar/resource_type/c_6501