{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T20:57:12Z","timestamp":1794430632098,"version":"4.9.1"},"reference-count":33,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2022,10,1]]},"abstract":"<jats:sec id=\"ab-hoi220046-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Early data revealed a mortality rate of 1% to 2% per hour for type A acute aortic dissection (TAAAD) during the initial 48 hours. Despite advances in diagnostic testing and treatment, this mortality rate continues to be cited because of a lack of contemporary data characterizing early mortality and the effect of timely surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi220046-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine early mortality rates for patients with TAAAD in the contemporary era.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi220046-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This cohort study examined data for patients with TAAAD in the International Registry of Acute Aortic Dissection between 1996 and 2018. Patients were grouped according to the mode of their intended treatment, surgical or medical.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi220046-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Surgical treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi220046-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Mortality was assessed in the initial 48 hours after hospital arrival using Kaplan-Meier curves. In-hospital complications were also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi220046-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 5611 patients with TAAAD were identified based on intended treatment: 5131 (91.4%) in the surgical group (3442 [67.1%] male; mean [SD] age, 60.4 [14.1] years) and 480 (8.6%) in the medical group (480 [52.5%] male; mean [SD] age, 70.9 [14.7] years). Reasons for medical management included advanced age (n\u2009=\u2009141), comorbidities (n\u2009=\u2009281), and patient preference (n\u2009=\u200981). Over the first 48 hours, the mortality for all patients in the study was 5.8%. Among patients who were medically managed, mortality was 0.5% per hour (23.7% at 48 hours). For those whose intended treatment was surgical, 48-hour mortality was 4.4%. In the surgical group, 51 patients (1%) died before the operation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi220046-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this study, the overall mortality rate for TAAAD was 5.8% at 48 hours. For patients in the medical group, TAAAD had a mortality rate of 0.5% per hour (23.7% at 48 hours). However, among those in the surgical group, 48-hour mortality decreased to 4.4%.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamacardio.2022.2718","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T11:32:13Z","timestamp":1661340733000},"page":"1009","source":"Crossref","is-referenced-by-count":277,"title":["Early Mortality in Type A Acute Aortic Dissection"],"prefix":"10.1001","volume":"7","author":[{"given":"Kevin M.","family":"Harris","sequence":"first","affiliation":[{"name":"Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph A.","family":"Nienaber","sequence":"additional","affiliation":[{"name":"The Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark 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