CT findings of type A acute aortic dissection that did and did not result in prehospital death

• 資料種別: 記事
• タイトル: CT findings of type A acute aortic dissection that did and did not result in prehospital death
• 著者標目: Sueyoshi, Eijun; Murakami, Tomonori; He, Xi; Uetani, Masataka; Koike, Hirofumi; Nagayama, Hiroki
• 出版年月日等: 2022-01-28
• 出版年（W3CDTF）: 2022-01-28
• タイトル（掲載誌）: Medicine
• 巻号年月日等（掲載誌）: 101 4
• 掲載巻: 101
• 掲載号: 4
• 掲載ページ: e28657-
• 掲載年月日（W3CDTF）: 2022-01-28
• ISSN（掲載誌）: 00257974; 15365964
• 出版事項（掲載誌）: Wolters Kluwer Health, Inc.
• 本文の言語コード: en
• 件名標目: acute aortic dissection; complication; CT; sudden death; type A
• 対象利用者: 一般
• 標準番号（その他）: PMID : 35089207
• DOI: 10.1097/md.0000000000028657; https://doi.org/10.1097/md.0000000000028657
• オンライン閲覧公開範囲: インターネット公開
• 著作権情報: © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
• 関連情報（URI）: http://hdl.handle.net/10069/00041297; https://nagasaki-u.repo.nii.ac.jp/records/27136
• 連携機関・データベース: 国立情報学研究所 : CiNii Research; https://cir.nii.ac.jp/
• 提供元機関・データベース: 学術機関リポジトリデータベース; https://irdb.nii.ac.jp

• 要約等: The differences between the pathologies of cases of type A acute aortic dissection (AAD) that did and did not result in prehospital death (PHD) have not been fully elucidated. This study aimed to compare the CT findings and clarify the differences between the pathologies of such cases. Ninety four consecutive type A AAD patients between 2010 and 2020 were enrolled in this study. There were 47 males and 47 females (mean age: 69.0 ± 14.4 years). The patients were divided into those that did (n = 25, 27%) and did not (n = 69, 73%) suffer PHD. We retrospectively evaluated the CT or postmortem CT findings of each case and analyzed the relationships between clinical factors (CT findings and clinical characteristics) and PHD using logistic regression analysis. Bloody pericardial effusion (96% vs 35%, P < .0001), bloody pleural effusion (40% vs 1%, P < .0001), and mediastinal hematomas (88% vs 14%, P < .0001) were significantly more common in the PHD group than in the no PHD group. In the multivariate logistic regression analysis, bloody pericardial effusion and lung consolidation were found to be significant risk factors for PHD (odds ratio: 21.29 [95% confidence intervals {CI}: 1.19–248.29] and 13.72 [95% CI: 1.79–105.06], respectively; P = .014 and P = .012, respectively). AD affecting the abdominal aorta was identified as a significant negative risk factor for PHD (odds ratio: 0.02 [95% CI: 0.01–0.65]; P = .0042). Most PHD due to type A AAD are associated with hemorrhaging. Bleeding into the pericardium and type A AAD confined to the thoracic aorta are significant risk factors for PHD. Secondary respiratory failure might contribute to PHD in such cases.
• オンライン閲覧公開範囲: インターネット公開
• 著作権情報: © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
• 関連情報（DOI）: 10.1097/MD.0000000000028657; https://doi.org/10.1097/MD.0000000000028657
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 長崎大学 : 長崎大学学術研究成果リポジトリ