{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:01:40Z","timestamp":1787022100457,"version":"build-2736575974"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T00:00:00Z","timestamp":1644451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CMRPG3L0101"],"award-info":[{"award-number":["CMRPG3L0101"]}],"id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST-110-2314-B-182A-114"],"award-info":[{"award-number":["MOST-110-2314-B-182A-114"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study is to evaluate the sex-related differences on the risks of perioperative and late outcomes for adult acute aortic dissection (AAD) patients following surgical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>By using Taiwan National Health Insurance Research Database, totally 1,410 female and 3,432 male patients were identified to first-ever receive type A AAD open surgery or type B AAD stenting treatment from 2004 to 2013. We assessed the sex-related difference on outcomes, including in-hospital mortality, all-cause mortality, aortic death, redo aortic surgery, ischemic stroke, and depression during the follow-up period. The analysis was done separately for type A and type B surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>On average, female patients diagnosed with AAD were older than males. There was no significant sex difference of in-hospital mortality or all-cause mortality for both type A open and type B stent surgeries. The risk of redo aortic surgery was significantly greater in males than females (7.8% vs. 4%; unadjusted subdistribution hazard ratio [SHR] 0.51, 95% CI 0.38\u20130.69) for type A open surgery, but not for type B stent surgery. Noticeably, the risk of newly-diagnosed depression was significantly greater in females than males (8% vs. 5.1%; unadjusted SHR 1.6, 95% CI 1.24\u20132.06) for type A open surgery, but not for type B stent surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>No significant sex-related difference was found for the in-hospital mortality or accumulative all-cause mortality. However, there were more redo aortic surgeries for males and more postoperative depression for females in type A AAD population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0263717","type":"journal-article","created":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T13:31:07Z","timestamp":1644499867000},"page":"e0263717","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Sex-related differences on the risks of in-hospital and late outcomes after acute aortic dissection: A nationwide population-based cohort study"],"prefix":"10.1371","volume":"17","author":[{"given":"Fang-Ting","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An-Hsun","family":"Chou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Hsin","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Chien-Chia","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7959-7804","authenticated-orcid":true,"given":"Chia-Pin","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo-Chun","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pao-Hsien","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Ting","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1674-1295","authenticated-orcid":true,"given":"Shao-Wei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,2,10]]},"reference":[{"issue":"17","key":"pone.0263717.ref001","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1161\/CIRCULATIONAHA.117.031264","article-title":"Insights From the International Registry of Acute Aortic Dissection: A 20-Year Experience of Collaborative Clinical Research","volume":"137","author":"A Evangelista","year":"2018","journal-title":"Circulation"},{"issue":"24","key":"pone.0263717.ref002","doi-asserted-by":"crossref","first-page":"3014","DOI":"10.1161\/01.CIR.0000130644.78677.2C","article-title":"Gender-related differences in acute aortic dissection","volume":"109","author":"CA Nienaber","year":"2004","journal-title":"Circulation"},{"key":"pone.0263717.ref003","article-title":"Gender-related differences in patients with acute aortic dissection type A","author":"B Rylski","year":"2019","journal-title":"The Journal of thoracic and cardiovascular surgery"},{"issue":"2","key":"pone.0263717.ref004","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1053\/j.semtcvs.2011.08.009","article-title":"Sex and gender in thoracic aortic aneurysms and dissection","volume":"23","author":"KJ Grubb","year":"2011","journal-title":"Seminars in thoracic and cardiovascular surgery"},{"issue":"3","key":"pone.0263717.ref005","first-page":"7","article-title":"risk of heart disease","volume":"19","author":"Gilmour H. Depression","year":"2008","journal-title":"Health reports"},{"issue":"Pt B","key":"pone.0263717.ref006","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.neubiorev.2016.04.023","article-title":"Behavioral, emotional and neurobiological determinants of coronary heart disease risk in women","volume":"74","author":"V Vaccarino","year":"2017","journal-title":"Neuroscience and biobehavioral reviews"},{"issue":"5","key":"pone.0263717.ref007","first-page":"676","article-title":"Gender-Based Differences in Anxiety and Depression Following Acute Myocardial Infarction","volume":"111","author":"P Serpytis","year":"2018","journal-title":"Arquivos brasileiros de cardiologia"},{"issue":"4","key":"pone.0263717.ref008","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1016\/j.jtcvs.2018.04.064","article-title":"Nationwide cohort study of mitral valve repair versus replacement for infective endocarditis","volume":"156","author":"HA Lee","year":"2018","journal-title":"The Journal of thoracic and cardiovascular surgery"},{"issue":"1","key":"pone.0263717.ref009","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.athoracsur.2018.01.067","article-title":"Long-Term Outcomes for Patients With Stroke After Coronary and Valve Surgery","volume":"106","author":"CC Chen","year":"2018","journal-title":"The Annals of thoracic surgery"},{"issue":"8","key":"pone.0263717.ref010","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1253\/circj.CJ-18-0003","article-title":"Propensity Score Matched Analysis of Mechanical vs. Bioprosthetic Valve Replacement in Patients With Previous Stroke","volume":"82","author":"SW Chen","year":"2018","journal-title":"Circulation journal: official journal of the Japanese Circulation Society"},{"issue":"5","key":"pone.0263717.ref011","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1016\/j.jvs.2018.06.225","article-title":"A population-based analysis of endovascular aortic stent graft therapy in patients with liver cirrhosis","volume":"69","author":"AH Chou","year":"2019","journal-title":"Journal of vascular surgery"},{"issue":"9632","key":"pone.0263717.ref012","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/S0140-6736(08)60994-0","article-title":"Acute aortic dissection","volume":"372","author":"J Golledge","year":"2008","journal-title":"Lancet (London, England)."},{"issue":"18","key":"pone.0263717.ref013","doi-asserted-by":"crossref","first-page":"e017147","DOI":"10.1161\/JAHA.120.017147","article-title":"Outcomes of Acute Aortic Dissection Surgery in Octogenarians","volume":"9","author":"ME Hsu","year":"2020","journal-title":"Journal of the American Heart Association"},{"issue":"4","key":"pone.0263717.ref014","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.jcin.2008.04.009","article-title":"Complicated acute type B dissection: is surgery still the best option?: a report from the International Registry of Acute Aortic Dissection","volume":"1","author":"R Fattori","year":"2008","journal-title":"JACC Cardiovascular interventions"},{"issue":"11 Suppl","key":"pone.0263717.ref015","first-page":"I150","article-title":"Acute type B aortic dissection: does aortic arch involvement affect management and outcomes? Insights from the International Registry of Acute Aortic Dissection (IRAD)","volume":"116","author":"TT Tsai","year":"2007","journal-title":"Circulation"},{"issue":"18","key":"pone.0263717.ref016","doi-asserted-by":"crossref","first-page":"1906","DOI":"10.1001\/2012.jama.11975","article-title":"Association between nucleoside analogues and risk of hepatitis B virus\u2013related hepatocellular carcinoma recurrence following liver resection","volume":"308","author":"CY Wu","year":"2012","journal-title":"Jama"},{"issue":"9","key":"pone.0263717.ref017","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1161\/CIRCULATIONAHA.118.035805","article-title":"Sex-Related Differences in Patients Undergoing Thoracic Aortic Surgery","volume":"139","author":"J Chung","year":"2019","journal-title":"Circulation"},{"issue":"1","key":"pone.0263717.ref018","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1186\/s13019-020-01189-w","article-title":"Sex-specific risk factors for early mortality and survival after surgery of acute aortic dissection type a: a retrospective observational study","volume":"15","author":"C Friedrich","year":"2020","journal-title":"Journal of cardiothoracic surgery"},{"issue":"1","key":"pone.0263717.ref019","doi-asserted-by":"crossref","first-page":"e001513","DOI":"10.1161\/JAHA.114.001513","article-title":"Risk profiles for aortic dissection and ruptured or surgically treated aneurysms: a prospective cohort study","volume":"4","author":"M Landenhed","year":"2015","journal-title":"Journal of the American Heart Association"},{"issue":"26","key":"pone.0263717.ref020","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1093\/eurheartj\/ehaa446","article-title":"Sex differences and temporal trends in aortic dissection: a population-based study of incidence, treatment strategies, and outcome in Swedish patients during 15 years","volume":"41","author":"C Smedberg","year":"2020","journal-title":"European heart journal"},{"issue":"3","key":"pone.0263717.ref021","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.jtcvs.2015.06.031","article-title":"Gender differences in patients undergoing surgery for acute type A aortic dissection","volume":"150","author":"T Fukui","year":"2015","journal-title":"The Journal of thoracic and cardiovascular surgery"},{"issue":"1","key":"pone.0263717.ref022","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1055\/s-0039-1687900","article-title":"Effects of Sex on Early Outcome following Repair of Acute Type A Aortic Dissection: Results from The Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD).","volume":"7","author":"RA Chemtob","year":"2019","journal-title":"Aorta (Stamford, Conn)."},{"issue":"6","key":"pone.0263717.ref023","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1093\/icvts\/ivy005","article-title":"Clinical differences between men and women undergoing surgery for acute Type A aortic dissection","volume":"26","author":"T Suzuki","year":"2018","journal-title":"Interactive cardiovascular and thoracic surgery"},{"key":"pone.0263717.ref024","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.avsg.2016.06.006","article-title":"Effects of Gender Differences on Short-term Outcomes in Patients with Type B Aortic Dissection.","volume":"38","author":"NL Liang","year":"2017","journal-title":"Annals of vascular surgery"},{"issue":"1","key":"pone.0263717.ref025","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1001\/archpsyc.1994.03950010008002","article-title":"Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey","volume":"51","author":"RC Kessler","year":"1994","journal-title":"Archives of general psychiatry"},{"issue":"4","key":"pone.0263717.ref026","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1001\/jama.1996.03540040037030","article-title":"Cross-national epidemiology of major depression and bipolar disorder","volume":"276","author":"MM Weissman","year":"1996","journal-title":"Jama"},{"issue":"7","key":"pone.0263717.ref027","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1080\/02699931.2013.875889","article-title":"Sex differences in the ability to recognise non-verbal displays of emotion: a meta-analysis","volume":"28","author":"AE Thompson","year":"2014","journal-title":"Cognition & emotion"},{"issue":"6","key":"pone.0263717.ref028","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1176\/appi.ajp.157.6.924","article-title":"Effects of gonadal steroids in women with a history of postpartum depression","volume":"157","author":"M Bloch","year":"2000","journal-title":"The American journal of psychiatry"},{"issue":"10","key":"pone.0263717.ref029","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1016\/j.jacc.2020.07.028","article-title":"Association of Family History With Incidence and Outcomes of Aortic Dissection","volume":"76","author":"SW Chen","year":"2020","journal-title":"Journal of the American College of Cardiology"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0263717","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T09:54:17Z","timestamp":1674726857000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0263717"}},"subtitle":[],"editor":[{"given":"Janet","family":"Powell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,2,10]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0263717","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,10]]}}}