Population-based incidence and outcomes of acute aortic dissection in Japan
| Autor: | Yousuke Inoue, Yoshihiro Miyamoto, Hitoshi Matsuda, Kenji Minatoya, Yuichi Ueda, Takao Yano, Tetsuo Yamaguchi, Hideaki Yoshino, Masakazu Matsuyama, Yutaka Okita, Michikazu Nakai, Yoko Sumita, Hitoshi Ogino |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty Population Autopsy Population based 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Japan medicine Humans 030212 general & internal medicine education Retrospective Studies Aortic dissection education.field_of_study business.industry Incidence (epidemiology) Mortality rate Incidence General Medicine Japanese population medicine.disease Aortic Aneurysm Aortic Dissection Acute Disease High incidence Cardiology and Cardiovascular Medicine business |
| Zdroj: | European heart journal. Acute cardiovascular care. 10(7) |
| ISSN: | 2048-8734 |
| Popis: | Aims The population-based incidence and outcomes of acute aortic dissection (AAD) are still unknown because some patients are already dead on arrival, and the accurate diagnosis of AAD is difficult due to the low autopsy rate. We performed a population-based review of all patients with AAD in a well-defined geographical area in Japan between 2016 and 2018. Methods and results Data of all patients with AAD at Miyazaki Prefectural Nobeoka Hospital (MPNH), which performs medical care for 120 000 residents, were collected retrospectively. The emergency medical service is dedicated to the transfer of all patients in this area to the MPNH. For all patients who were dead on arrival, the diagnosis of AAD was made by autopsy imaging (AI) using computed tomography. The age-adjusted incidence and mortality per 100 000 population were calculated using the Japanese population distribution model in 2015. The total incidence of AAD was 79 (type A: 64.5%, n = 51). Of those, 60.8% (31/51) of patients with type A and 21.4% (6/28) with type B were dead on arrival and diagnosed by AI. The 30-day mortality rates were 74.5% (38/51) in type A and 25.0% (7/28) in type B. The age-adjusted incidence and mortality of AAD per 100 000 inhabitants were 17.6 (type A: 11.3, type B: 6.2) and 9.9 (type A: 8.4, type B: 1.5), respectively. Conclusions The population-based survey of AAD showed that the age-adjusted incidence of AAD was two-fold higher than in previous reports, and the actual mortality rates were markedly higher due to the high incidence of dead-on-arrival. |
| Databáze: | OpenAIRE |
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