{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T04:45:28Z","timestamp":1785127528072,"version":"3.55.0"},"reference-count":44,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,2,10]],"date-time":"2024-02-10T00:00:00Z","timestamp":1707523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Acute aortic dissection type A (AADA) is a surgical emergency with relevant mortality and morbidity despite improvements in current management protocols. Identifying patients at risk of a fatal outcome and controlling the factors associated with mortality remain of paramount importance. Methods: In this retrospective observational study, we reviewed the medical records of 117 patients with AADA, who were referred to our centre and operated on between 2005 and 2021. Preoperative, intraoperative, and postoperative variables were analysed and tested for their correlation with in-hospital mortality. Results: The overall survival rate was 83%. Preoperatively, factors associated with mortality were age (p = 0.02), chronic hypertension (p = 0.02), any grade of aortic valve stenosis in the patient\u2019s medical history (p = 0.03), atrial fibrillation (p = 0.04), and oral anticoagulation (p = 0.04). Non-survivors had significantly longer operative times (p = 0.002). During the postoperative phase, mortality was strongly associated with acute kidney injury (AKI) (p &lt; 0.001), acute heart failure (p &lt; 0.001), stroke (p = 0.02), focal neurological deficits (p = 0.02), and sepsis (p = 0.001). In the multivariate regression analysis, the onset of postoperative focal neurological deficits was the best predictor of a fatal outcome after adjusting for ARDS (odds ratio: 5.8, 95%-CI: 1.2\u201341.7, p = 0.04). Conclusions: In this retrospective analysis, atrial fibrillation, oral anticoagulation, hypertension, and age were significantly correlated with mortality. Postoperatively, acute kidney injury, acute heart failure, sepsis, and focal neurological deficits were correlated with in-hospital mortality, and focal neurological deficit has been identified as a significant predictor of fatal outcomes. Early detection and interdisciplinary management of at-risk patients remain crucial throughout the postoperative phase.<\/jats:p>","DOI":"10.3390\/jcm13041023","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T03:50:27Z","timestamp":1707709827000},"page":"1023","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Factors Associated with Early Mortality in Acute Type A Aortic Dissection\u2014A Single-Centre Experience"],"prefix":"10.3390","volume":"13","author":[{"given":"Panagiotis","family":"Doukas","sequence":"first","affiliation":[{"name":"European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, RWTH University Hospital Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Dalibor","sequence":"additional","affiliation":[{"name":"European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, RWTH University Hospital Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e1s","family":"Keszei","sequence":"additional","affiliation":[{"name":"Center for Translational & Clinical Research Aachen (CTC-A), RWTH Aachen University, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelle","family":"Frankort","sequence":"additional","affiliation":[{"name":"European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, RWTH University Hospital Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4205-9783","authenticated-orcid":false,"given":"Julia","family":"Krabbe","sequence":"additional","affiliation":[{"name":"Institute of Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2243-8743","authenticated-orcid":false,"given":"Rachad","family":"Zayat","sequence":"additional","affiliation":[{"name":"Clinic for Cardiac Surgery, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, RWTH University Hospital Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8451-2913","authenticated-orcid":false,"given":"Alexander","family":"Gombert","sequence":"additional","affiliation":[{"name":"European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, RWTH University Hospital Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6452-8678","authenticated-orcid":false,"given":"Payam","family":"Akhyari","sequence":"additional","affiliation":[{"name":"Clinic for Cardiac Surgery, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Mehdiani","sequence":"additional","affiliation":[{"name":"Clinic for Cardiac Surgery, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e885","DOI":"10.1097\/SLA.0000000000005840","article-title":"Current Outcome after Surgery for Type A Aortic Dissection","volume":"278","author":"Biancari","year":"2023","journal-title":"Ann. 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