{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T10:35:16Z","timestamp":1766054116357,"version":"3.48.0"},"reference-count":21,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Acute type A aortic dissection (ATAAD) remains a life-threatening condition requiring prompt surgical management. Over the last decades, improvements in diagnosis, surgical techniques, and perioperative care have influenced patient characteristics and outcomes. This study analyzes temporal trends in the clinical profiles and results of patients surgically treated for acute type A aortic dissection (ATAAD) in a Northern Italian region over a fifteen-year period. Materials and Methods: All consecutive patients undergoing emergency surgery for acute Stanford type A aortic dissection or acute intramural hematoma (IMH) between January 2010 and December 2024 were retrospectively reviewed. Patients with chronic penetrating atherosclerotic ulcer or traumatic etiology were excluded. Demographic, clinical, and perioperative variables were analyzed to assess temporal changes. Trends were evaluated using linear regression and Cochran\u2013Armitage tests for trend. Results: A total of 427 patients underwent surgery for AAD during the study period. The proportion of patients presenting with preoperative intubation significantly decreased over time (p for trend &lt; 0.05), as did the incidence of preoperative shock (p for trend &lt; 0.001). Conversely, the mean EuroSCORE showed a non-significant increase over the years. No significant differences were observed in age or other baseline parameters. A non-significant but progressive increase in female representation was observed over time (p = 0.064). Given this observation, a sex-based subanalysis was performed: women were significantly older (p &lt; 0.001) and presented with higher EuroSCORE values (p &lt; 0.001) compared to men, yet postoperative mortality was similar between sexes. This finding contrasts with recent reports suggesting worse outcomes among female patients. Conclusions: Over fifteen years, patients undergoing surgery for acute type A aortic dissection have shown decreasing rates of preoperative critical conditions, reflecting earlier diagnosis and improved management. Despite higher operative risk scores, women demonstrated comparable short-term survival to men within our regional program. Multivariable analysis showed that sex was dependently associated with in-hospital mortality.<\/jats:p>","DOI":"10.3390\/medicina61122236","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T10:06:56Z","timestamp":1766052416000},"page":"2236","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evolving Demographics and Outcomes in Surgically Treated Acute Type A Aortic Dissection: A Fifteen-Year Regional Experience"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2892-8700","authenticated-orcid":false,"given":"Elisa","family":"Mikus","sequence":"first","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1396-4330","authenticated-orcid":false,"given":"Mariafrancesca","family":"Fiorentino","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6666-3480","authenticated-orcid":false,"given":"Diego","family":"Sangiorgi","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3449-6986","authenticated-orcid":false,"given":"Antonino","family":"Costantino","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Calvi","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6974-0849","authenticated-orcid":false,"given":"Elena","family":"Tenti","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Milione","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Advanced Biomedical Sciences, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Valota","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40127 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Tripodi","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4197-7486","authenticated-orcid":false,"given":"Carlo","family":"Savini","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy"},{"name":"Department of Experimental Diagnostic and Surgical Medicine (DIMEC), University of Bologna, 40127 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"ezad426","DOI":"10.1093\/ejcts\/ezad426","article-title":"EACTS\/STS Scientific Document Group. 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