Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study
Background Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD. Methods We retrosp...
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| Format: | Article |
| Language: | English |
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Yeungnam University College of Medicine, Yeungnam University Institute Medical Science
2022-10-01
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| Series: | Journal of Yeungnam Medical Science |
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| Online Access: | http://www.e-jyms.org/upload/pdf/jyms-2021-01690.pdf |
| _version_ | 1811345277104160768 |
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| author | Chul Ho Lee Jae Seok Jang Jun Woo Cho |
| author_facet | Chul Ho Lee Jae Seok Jang Jun Woo Cho |
| author_sort | Chul Ho Lee |
| collection | DOAJ |
| description | Background Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD. Methods We retrospectively studied patients with uncomplicated ATBAD who were medically treated between January 2010 and July 2020. Patients were divided into short-term ICU stay (SIS) and long-term ICU stay (LIS) groups, according to a 48-hour cutoff of ICU stay duration. The incidence of pneumonia and delirium, rate of aortic events, hospital mortality, and survival rate were compared. Results Fifty-five patients were treated for uncomplicated ATBAD (n=29 for SIS and n=26 for LIS). The incidence of pneumonia (3.6% vs. 7.7%) and delirium (14.3% vs. 34.6%) was higher in the LIS group than in the SIS group, but the differences were not statistically significant. The survival rates at 1, 3, and 5 years were not different between the two groups (SIS: 96.4%, 92.2%, and 75.5% vs. LIS: 96.2%, 88.0%, and 54.2%, respectively; p=0.102). Multivariate Cox regression analysis for aortic events showed that using a calcium channel blocker lowered the risk of aortic events. Conclusion Long-term ICU treatment is unlikely to be necessary for the treatment of uncomplicated ATBAD. Active use of antihypertensive agents, such as calcium channel blockers, may be needed during the follow-up period. |
| first_indexed | 2024-04-13T20:00:44Z |
| format | Article |
| id | doaj.art-ef9591fcf53241f98a8b386dcfe6466f |
| institution | Directory Open Access Journal |
| issn | 2799-8010 |
| language | English |
| last_indexed | 2024-04-13T20:00:44Z |
| publishDate | 2022-10-01 |
| publisher | Yeungnam University College of Medicine, Yeungnam University Institute Medical Science |
| record_format | Article |
| series | Journal of Yeungnam Medical Science |
| spelling | doaj.art-ef9591fcf53241f98a8b386dcfe6466f2022-12-22T02:32:12ZengYeungnam University College of Medicine, Yeungnam University Institute Medical ScienceJournal of Yeungnam Medical Science2799-80102022-10-0139429429910.12701/jyms.2021.016902699Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational studyChul Ho Lee0Jae Seok Jang1Jun Woo Cho Department of Thoracic and Cardiovascular Surgery, Daegu Catholic University School of Medicine, Daegu, Korea Department of Thoracic and Cardiovascular Surgery, Daegu Catholic University School of Medicine, Daegu, KoreaBackground Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD. Methods We retrospectively studied patients with uncomplicated ATBAD who were medically treated between January 2010 and July 2020. Patients were divided into short-term ICU stay (SIS) and long-term ICU stay (LIS) groups, according to a 48-hour cutoff of ICU stay duration. The incidence of pneumonia and delirium, rate of aortic events, hospital mortality, and survival rate were compared. Results Fifty-five patients were treated for uncomplicated ATBAD (n=29 for SIS and n=26 for LIS). The incidence of pneumonia (3.6% vs. 7.7%) and delirium (14.3% vs. 34.6%) was higher in the LIS group than in the SIS group, but the differences were not statistically significant. The survival rates at 1, 3, and 5 years were not different between the two groups (SIS: 96.4%, 92.2%, and 75.5% vs. LIS: 96.2%, 88.0%, and 54.2%, respectively; p=0.102). Multivariate Cox regression analysis for aortic events showed that using a calcium channel blocker lowered the risk of aortic events. Conclusion Long-term ICU treatment is unlikely to be necessary for the treatment of uncomplicated ATBAD. Active use of antihypertensive agents, such as calcium channel blockers, may be needed during the follow-up period.http://www.e-jyms.org/upload/pdf/jyms-2021-01690.pdfacute type b aortic dissectionantihypertensive treatmentintensive care units |
| spellingShingle | Chul Ho Lee Jae Seok Jang Jun Woo Cho Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study Journal of Yeungnam Medical Science acute type b aortic dissection antihypertensive treatment intensive care units |
| title | Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study |
| title_full | Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study |
| title_fullStr | Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study |
| title_full_unstemmed | Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study |
| title_short | Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study |
| title_sort | intensive care unit management of uncomplicated type b aortic dissection in relation to treatment period a retrospective observational study |
| topic | acute type b aortic dissection antihypertensive treatment intensive care units |
| url | http://www.e-jyms.org/upload/pdf/jyms-2021-01690.pdf |
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