J Yeungnam Med Sci.  2022 Oct;39(4):294-299. 10.12701/jyms.2021.01690.

Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study

• Lee CH
• Jang JS
• Cho JW

• KMID: 2534656
• DOI: http://doi.org/10.12701/jyms.2021.01690

Abstract

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 long-term ICU stay (LIS) and short-term ICU stay (SIS) 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=26 for LIS and n=29 for SIS). The incidence of pneumonia (7.7% vs. 3.6%) and delirium (34.6% vs. 14.3%) 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 (LIS: 96.2%, 88.0%, and 54.2% vs. SIS: 96.4%, 92.2%, and 75.5%, 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.

Keyword

Acute type B aortic dissection; Antihypertensive treatment; Intensive care units

Figure

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  Fig. 1. Kaplan-Meier curves for survival in the short-term intensive care unit stay (SIS) and long-term intensive care unit stay (LIS) groups.

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  Fig. 2. Kaplan-Meier curves for freedom from aortic events in the short-term intensive care unit stay (SIS) and long-term intensive care unit stay (LIS) groups.

Reference

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