{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T17:08:03Z","timestamp":1784567283247,"version":"3.55.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The increasing prevalence of acute Stanford type A aortic dissection (ATAAD) among octogenarians necessitates robust, large-scale data to inform surgical decision-making and risk stratification. Thus, we investigated the multicentre Tokyo Acute Aortic Super-Network database to demonstrate in-hospital mortality trends in this vulnerable patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed patients with ATAAD transported to the network\u2019s participating hospitals between January 2015 and December 2022. The study population was stratified into 2 age-based groups: octogenarians (\u226580\u2009years) and non-octogenarians (&amp;lt;80\u2009years). Multivariate logistic regression analysis identified independent predictors of in-hospital mortality specifically within the octogenarian group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5361 patients, 1467 (27.4%) were octogenarians. Overall mortality was significantly higher in the octogenarians compared to non-octogenarians (34.5% vs 15.9%; P\u2009&amp;lt;\u2009.001), whereas operative mortality for those undergoing surgery remained acceptable (10.5% vs 8.1%; P\u2009=\u2009.035). Multivariable analysis revealed that open false lumen (odds ratio [OR], 3.77; 95% confidence interval [CI], 2.51-5.67; P\u2009&amp;lt;\u2009.001), shock at arrival (OR, 2.62; 95% CI, 1.68-4.08; P\u2009&amp;lt;\u2009.001), out-of-hospital cardiopulmonary arrest (OR, 18.99; 95% CI, 7.72-46.72; P\u2009&amp;lt;\u2009.001), in-hospital cardiopulmonary arrest (OR, 17.39; 95% CI, 6.21-48.67; P\u2009&amp;lt;\u2009.001), and cerebral malperfusion (OR, 2.17; 95% CI, 1.16-4.06; P\u2009=\u2009.016) were related to higher mortality in octogenarian patients. Conversely, surgical intervention (OR, 0.15; 95% CI, 0.10-0.22; P\u2009&amp;lt;\u2009.001) and higher serum albumin levels (OR, 0.65; 95% CI, 0.42-1.00; P\u2009=\u2009.049) were associated with lower risk of mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although octogenarians with ATAAD had higher overall mortality, operative mortality among selected patients undergoing surgery remained acceptable, suggesting that advanced age alone should not preclude surgical intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivag195","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T11:36:07Z","timestamp":1783424167000},"source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Acute Type A Aortic Dissection in Octogenarians: Tokyo Acute Aortic Super-Network Registry"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6396-0437","authenticated-orcid":false,"given":"Manabu","family":"Yamasaki","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Juntendo University , 2-2-1 Hongo, Bunkyoku , Tokyo, 113-8421,","place":["Japan"]},{"name":"Department of Cardiovsascular Surgery, Itabashi Chuo Medical Hospital , 2-12-17 Azusawa, Itabashiku , Tokyo, 174-0051,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4976-4055","authenticated-orcid":false,"given":"Hideaki","family":"Yoshino","sequence":"additional","affiliation":[{"name":"Tokyo CCU Network Scientific Committee , 2-23-1 Yoyogi, Shibuyaku , Tokyo151-0053,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kunihara","sequence":"additional","affiliation":[{"name":"Tokyo CCU Network Scientific Committee , 2-23-1 Yoyogi, Shibuyaku , Tokyo151-0053,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2306-0669","authenticated-orcid":false,"given":"Kojiro","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Nursing Administration and Advanced Clinical Nursing, Tokyo University , 7-3-1 Hongo, Bunkyoku , Tokyo, 113-0033,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Akutsu","sequence":"additional","affiliation":[{"name":"Tokyo CCU Network Scientific Committee , 2-23-1 Yoyogi, Shibuyaku , Tokyo151-0053,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Shimokawa","sequence":"additional","affiliation":[{"name":"Tokyo CCU Network Scientific Committee , 2-23-1 Yoyogi, Shibuyaku , Tokyo151-0053,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Ogino","sequence":"additional","affiliation":[{"name":"Tokyo CCU Network Scientific Committee , 2-23-1 Yoyogi, Shibuyaku , Tokyo151-0053,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Kawata","sequence":"additional","affiliation":[{"name":"Tokyo CCU Network Scientific Committee , 2-23-1 Yoyogi, Shibuyaku , Tokyo151-0053,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Tokyo CCU Network Scientific Committee , 2-23-1 Yoyogi, Shibuyaku , Tokyo151-0053,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6588-3305","authenticated-orcid":false,"given":"Michio","family":"Usui","sequence":"additional","affiliation":[{"name":"Tokyo CCU Network Scientific Committee , 2-23-1 Yoyogi, Shibuyaku , Tokyo151-0053,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshiro","family":"Fujii","sequence":"additional","affiliation":[{"name":"Tokyo CCU Network Scientific Committee , 2-23-1 Yoyogi, Shibuyaku , Tokyo151-0053,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3779-2972","authenticated-orcid":false,"given":"Shun","family":"Kohsaka","sequence":"additional","affiliation":[{"name":"Tokyo CCU Network Scientific Committee , 2-23-1 Yoyogi, Shibuyaku , Tokyo151-0053,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Tokyo CCU Network Scientific Committee , 2-23-1 Yoyogi, Shibuyaku , Tokyo151-0053,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morimasa","family":"Takayama","sequence":"additional","affiliation":[{"name":"Tokyo CCU Network Scientific Committee , 2-23-1 Yoyogi, Shibuyaku , Tokyo151-0053,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"2026072012504179600_ivag195-B1","author":"Ministry of Internal Affairs and Communications, Japan","year":"2025"},{"key":"2026072012504179600_ivag195-B2","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jtcvs.2023.08.040","article-title":"A new insight into superacute care for type A acute aortic dissection in the Tokyo Acute Aortic Super Network","volume":"167","author":"Ogino","year":"2024","journal-title":"J Thorac Cardiovasc 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