The Clinical Presentation and Correlation, Prognosis in Elderly Aortic Dissection Patients with Hypotension

Abstract

Background: Aortic dissection (AD) is an emergent cardiovascular disease in the emergency department (ED). Objective: To investigate the clinical manifestation and outcomes in patients with aortic dissection accompanied by greater mediastinal width (MW) and hypotension status, and make further comparisons. Methods: We studied retrospectively 127 AD cases in 6 consecutive years from January, 1, 2005 to December, 31, 2010 from the ED. We gathered the data of sex, age, time and season of episodes, medical histories, symptoms, and heart rate at triage, and further assessed MW and hypotensive status, and related them to clinical outcome (died or survival to discharge). Results: In total, 58 men and 20 women enrolled in this study (mean age, 65 ± 13 years). The MW in the elderly was greater than nonelderly (9.9 ± 1.9 cm vs. 9.4 ± 1.8 cm, p = 0.04). AD patients who presented to ED with hypotension have significantly higher D-dimer level, longer hospital stay, and higher mortality rate. Conclusion: AD and larger MW are associated with being elderly and of hypotensive status. In addition, AD patients with hypotension may have longer hospital stay and higher mortality rate.

Keywords

• aortic dissection
• elderly
• hypotension
• mediastinum
• mortality