Introduction. Primary morbidity of acute aortic syndrome (AAS) tends to increase and in 2013 makes up 6 cases per 100 000 population.
Surgical hospital mortality is still high (23–30%). Objective data about overall hospital mortality (surgical and nonsurgical)
and the predictors of its occurrence are underrepresented or absent.
Objective. To identify organizational risk factors (predictors) of an adverse treatment outcome for patients with AAS.
Materials and methods. 425 cases of thoracic aorta acute pathology treated from 2010 to 2018 were analyzed. Level, structure and
predisposing factors of overall hospital mortality were determined by the single and multivariate statistical analysis.
Results. Overall hospital mortality was 40.5% (172 patients). 125 patients died without specific surgery and with incorrect diagnosis.
Statistically confirmed organizational and diagnostic predictors of overall hospital mortality in patients with AAS were: primary
admission in a non-specialized hospital (Оdds ratio (OR) 7.1; p< 0.001) and long term from the onset of the disease to surgery
(ОR for each 1 day 1.1; p = 0.037). Timely diagnostic procedures performance: transthoracic echocardiography (ОR 0.03;
p< 0.001), computer tomography (CT) angiography of the thoracic aorta (ОR = 0.21; p = 0.004), coronary angiography or CT coronary
angiography (ОR 0.44; p = 0.022); and surgery for AAS (ОR 0.02; p< 0.001) decreased mortality.
Conclusion. Verified routing, timely management and surgical treatment have a high potential ability for reducing overall hospital
mortality in patients with AAS.
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About the authors
- Gennadiy G. Khubulava, Dr Med. Sc., Professor, Academician of Russian Academy of Sciences, Chief of Chair, orcid.org/0000-0002-9242-9941
Nazim N. Shikhverdiev, Dr Med. Sc., Professor, orcid.org/0000-0002-7408-1558
Andrey S. Peleshok, Cand. Med. Sc., Associate Professor, orcid.org/0000-0001-5809-8024
Vyacheslav N. Kravchuk, Dr Med. Sc., Professor, orcid.org/0000-0002-6337-104X
Vladimir A. Krivopalov, Cand. Med. Sc., Cardiovascular Surgeon, orcid.org/0000-0001-5809-9216
Andrey M. Volkov, Dr Med. Sc., Associate Professor, orcid.org/0000-0002-4397-4230
Aleksandr I. Lyubimov, Cand. Med. Sc., Head of Department, orcid.org/0000-0002-7872-9593
Dmitriy I. Ushakov, Cardiovascular Surgeon, orcid.org/0000-0003-4504-3250
Artyom A. Payvin, Dr Med. Sc., Head of Department, orcid.org/0000-0003-0937-3009
Magomedehmin A. Askerov, Cand. Med. Sc., Head of Department, orcid.org/0000-0002-5151-3565
Demis G. Gramatikov, Head of Department, orcid.org/0000-0002-8175-7296
Artur T. Kamal’dinov, student, orcid.org/0000-0002-9201-5669