Computed tomography findings and in-hospital mortality in patients with rupture of type B aortic dissection

Abstract

Background The relationships between the computed tomography (CT) findings and outcomes of patients with ruptured type B aortic dissection have not been clarified. Purpose To evaluate the initial CT findings of patients with ruptured type B aortic dissection and investigate the relationships between the initial CT findings and in-hospital mortality. Material and Methods This study was approved by the institutional review board. Thirty-three patients were diagnosed with ruptured Stanford type B aortic dissection at our hospital between 2007 and 2016 (21 men, 12 women; mean age = 76.1±10.7 years). We retrospectively evaluated the initial CT findings of ruptured type B aortic dissection and the relationships between clinical factors and in-hospital mortality using logistic regression analysis. Results Type B aortic dissections ruptured in the acute and chronic phases in 23 and 10 patients, respectively. The initial CT images showed various findings, including an open false lumen (58%), arch involvement (88%), hematomas in the pleural space (55%), hematomas in the pericardial space (18%), and the extravasation of vascular contrast material (12%). The mean maximum diameter of the affected aorta was 49.5 ± 16.1 mm. Among the 33 patients, 14 died at hospital. Female gender (hazard ratio = 10.284; 95% confidence interval [CI] = 1.61–65.54; P = 0.0136) and the presence of a hematoma in the pleural space (hazard ratio = 6.803; 95% CI = 1.07–43.24; P = 0.0421) were found to be predictors of in-hospital mortality. Conclusion Female gender and the presence of a hematoma in the pleural space are significant predictors of in-hospital mortality in patients with ruptured type B aortic dissection.