Renal Dysfunction on Admission as a Predictor for In-Hospital Mortality of Patients with Stanford Type B Acute Aortic Dissection

Abstract

Stanford type A and open false lumen are accepted predictors for in-hospital mortality in patients with acute aortic dissection (AAD). However, the association of renal dysfunction on admission with in-hospital mortality is not well known. The aim of this study was to investigate the prognostic value of renal dysfunction in patients with AAD. A total of 250 patients with type B AAD admitted to our institution between January 2003 and August 2011 were enrolled in this study. In multivariate logistic regression analysis, the significant predictors of in-hospital mortality were age (odds ratio [OR] 1.575, 95% confidence interval [CI] 1.078-2.864, p = 0.024), maximum aortic diameter measured by an initial computed tomography (CT) (OR 1.740, 95% CI 1.029-2.940, p = 0.039), decreased enhancement of kidney (OR 7.716, 95% CI 2.335-25.501, p = 0.001) and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m(2) on admission (OR 2.782, 95% CI 1.062-7.283, p = 0.037). In conclusions the results identified a renal dysfunction on admission as the independent predictor of in-hospital mortality in type B AAD. Further investigations are needed to evaluate therapies and strategies for decreasing the deterioration of renal function to improve in-hospital mortality in patients with AAD.