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Women With Acute Aortic Dissection Have Higher Prehospital Mortality Than Men.
Marume, Kyohei; Noguchi, Teruo; Kaichi, Ryota; Yano, Takao; Matsuyama, Masakazu; Nagamine, Yasuhiro; Mori, Takayuki; Mikami, Takafumi; Ikebe, Sou; Takae, Masafumi; Komaki, Soichi; Ishii, Masanobu; Toida, Reiko; Kurogi, Kazumasa; Inoue, Yosuke; Matsuda, Hitoshi; Murata, Shunsuke; Nakaoku, Yuriko; Ogata, Soshiro; Nishimura, Kunihiro; Nakashima, Takahiro; Yamaguchi, Tetsuro; Yamamoto, Nobuyasu; Tsujita, Kenichi.
Afiliación
  • Marume K; Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
  • Noguchi T; Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
  • Kaichi R; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Yano T; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Matsuyama M; Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
  • Nagamine Y; Department of Critical Care and Emergency Medicine, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
  • Mori T; Department of Cardiovascular surgery, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
  • Mikami T; Department of Emergency Center, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
  • Ikebe S; Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
  • Takae M; Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
  • Komaki S; Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
  • Ishii M; Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
  • Toida R; Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
  • Kurogi K; Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
  • Inoue Y; Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
  • Matsuda H; Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
  • Murata S; Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Nakaoku Y; Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Ogata S; Department of Statistics and Data Analysis, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Nishimura K; Department of Statistics and Data Analysis, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Nakashima T; Department of Statistics and Data Analysis, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Yamaguchi T; Department of Statistics and Data Analysis, National Cerebral and Cardiovascular Center, Suita, Japan.
  • Yamamoto N; Department of Emergency Medicine and Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, Michigan, USA.
  • Tsujita K; Department of Internal Medicine, Miyazaki Prefectural Nobeoka Hospital, Miyazaki, Japan.
JACC Adv ; 2(8): 100623, 2023 Oct.
Article en En | MEDLINE | ID: mdl-38938331
ABSTRACT

Background:

Acute aortic dissection (AAD) often leads to out-of-hospital cardiac arrest (OHCA) and death before hospital arrival.

Objectives:

The purpose of this study was to investigate differences in AAD incidence by sex.

Methods:

A population-based study in a city with 121,180 residents was conducted using postmortem computed tomography data to identify patients with AAD who died before hospital arrival in 2008-2020. The incidence rate ratio and odds ratio were estimated using Poisson regression and univariable logistic regression, respectively.

Results:

A total of 266 patients with incident AAD were enrolled 84 patients with OHCA, 137 women [n = 137], and 164 patients with type A AAD. The crude and age-adjusted incidence of AAD was 16.2 and 14.3/100,000 person-years, respectively. The incidence of AAD was comparable by sex (men, 16.7/100,000 person-years; women, 15.7/100,000 person-years; incidence rate ratio 0.94; 95% CI 0.74-1.20; P = 0.64). Compared with men with AAD, women with AAD were older (77 ± 11 years vs 70 ± 14 years; P < 0.001), and a higher proportion had type A AAD (76% vs 47%; P < 0.001). Women with AAD had higher prehospital mortality than men with AAD (37% vs 21%; P = 0.004; OR 2.24; 95% CI 1.30-3.87; P = 0.004). Among 1,373 patients with OHCA, the proportion of women with AAD was significantly higher than the proportion of men with AAD (11% vs 3.9%; P < 0.001; OR 2.90; 95% CI 1.86-4.53; P < 0.001). AAD was most common in women aged 60 to 69 years (16.4%).

Conclusions:

Women had a higher incidence of AAD presenting as prehospital death than men.
Palabras clave

Texto completo: 1 Base de datos: MEDLINE Idioma: En Revista: JACC Adv Año: 2023 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Idioma: En Revista: JACC Adv Año: 2023 Tipo del documento: Article