Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection

Background: Acute type A aortic dissection (AAAD) is considered a fatal disease which requires an emergent surgical intervention. This study focuses onthe neurological outcome after surgical repair in cases of AAAD in comparison between elderly and young patients. Methods: a retrospective analysis o...
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Autor*in:	Mohamed Salem [verfasserIn] Michael Salib [verfasserIn] Christine Friedrich [verfasserIn] Mostafa Salem [verfasserIn] Thomas Puehler [verfasserIn] Jan Schoettler [verfasserIn] Felix Schoeneich [verfasserIn] Jochen Cremer [verfasserIn] Assad Haneya [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	acute type A aortic dissection moderate hypothermic circulatory arrest neurological complication in elderly after type A aortic dissection

Übergeordnetes Werk:	In: Journal of Clinical Medicine - MDPI AG, 2013, 10(2021), 8, p 1643
Übergeordnetes Werk:	volume:10 ; year:2021 ; number:8, p 1643

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3390/jcm10081643

Katalog-ID:	DOAJ016780345

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520			\|a Background: Acute type A aortic dissection (AAAD) is considered a fatal disease which requires an emergent surgical intervention. This study focuses onthe neurological outcome after surgical repair in cases of AAAD in comparison between elderly and young patients. Methods: a retrospective analysis of 368 consecutive patients who underwent emergency surgery of ascending aorta in moderate hypothermic circulatory arrest (MHCA) (20–24 °C) and antegrade cerebral perfusion after AAAD between 2001 and 2016. Patients were divided into two groups: those aged 75 years and older (68 (18.5%)) and those younger than 75 years (300 (81.5%)). Results: Comparing both groups, average age was 79.0 ± 3.2 vs. 59.2 ± 10.7 years (<i<p</i< < 0.001); female gender represents 58.8% of elderly patients vs. 28.7% in younger patients (<i<p</i< < 0.001). Intraoperatively, cardiopulmonary bypass time (155 min (131; 187) vs. 171 min (137; 220); <i<p</i< = 0.012), cross-clamping time (79 min (60; 105) vs. 93 min (71; 134); <i<p</i< = 0.001] and circulatory arrest time (29 min (22; 40) vs. 33 min (26; 49); <i<p</i< = 0.011) were significantly shorter in elderly than younger group. Postoperatively, there was no significant difference in delirium (11.8% vs. 20.5%; <i<p</i< = 0.0968) or stroke (11.8% vs. 16.1%; <i<p</i< = 0.369). The 30-day mortality was satisfactory for both groups but significantly higher in the elderly group (27.9% vs. 14.3%; <i<p</i< = 0.007). Conclusion: The current study concluded that surgical treatment of AAAD in elderly patients can be applied safely without increasing risk of neurological complication. However, minimizing operation time may help limit the occurrence of postoperative neurological complication.
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allfields	10.3390/jcm10081643 doi (DE-627)DOAJ016780345 (DE-599)DOAJ17994e0eb72a43969a3075ffed32b425 DE-627 ger DE-627 rakwb eng Mohamed Salem verfasserin aut Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Acute type A aortic dissection (AAAD) is considered a fatal disease which requires an emergent surgical intervention. This study focuses onthe neurological outcome after surgical repair in cases of AAAD in comparison between elderly and young patients. Methods: a retrospective analysis of 368 consecutive patients who underwent emergency surgery of ascending aorta in moderate hypothermic circulatory arrest (MHCA) (20–24 °C) and antegrade cerebral perfusion after AAAD between 2001 and 2016. Patients were divided into two groups: those aged 75 years and older (68 (18.5%)) and those younger than 75 years (300 (81.5%)). Results: Comparing both groups, average age was 79.0 ± 3.2 vs. 59.2 ± 10.7 years (<i<p</i< < 0.001); female gender represents 58.8% of elderly patients vs. 28.7% in younger patients (<i<p</i< < 0.001). Intraoperatively, cardiopulmonary bypass time (155 min (131; 187) vs. 171 min (137; 220); <i<p</i< = 0.012), cross-clamping time (79 min (60; 105) vs. 93 min (71; 134); <i<p</i< = 0.001] and circulatory arrest time (29 min (22; 40) vs. 33 min (26; 49); <i<p</i< = 0.011) were significantly shorter in elderly than younger group. Postoperatively, there was no significant difference in delirium (11.8% vs. 20.5%; <i<p</i< = 0.0968) or stroke (11.8% vs. 16.1%; <i<p</i< = 0.369). The 30-day mortality was satisfactory for both groups but significantly higher in the elderly group (27.9% vs. 14.3%; <i<p</i< = 0.007). Conclusion: The current study concluded that surgical treatment of AAAD in elderly patients can be applied safely without increasing risk of neurological complication. However, minimizing operation time may help limit the occurrence of postoperative neurological complication. acute type A aortic dissection moderate hypothermic circulatory arrest neurological complication in elderly after type A aortic dissection Medicine R Michael Salib verfasserin aut Christine Friedrich verfasserin aut Mostafa Salem verfasserin aut Thomas Puehler verfasserin aut Jan Schoettler verfasserin aut Felix Schoeneich verfasserin aut Jochen Cremer verfasserin aut Assad Haneya verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 10(2021), 8, p 1643 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:10 year:2021 number:8, p 1643 https://doi.org/10.3390/jcm10081643 kostenfrei https://doaj.org/article/17994e0eb72a43969a3075ffed32b425 kostenfrei https://www.mdpi.com/2077-0383/10/8/1643 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 8, p 1643
spelling	10.3390/jcm10081643 doi (DE-627)DOAJ016780345 (DE-599)DOAJ17994e0eb72a43969a3075ffed32b425 DE-627 ger DE-627 rakwb eng Mohamed Salem verfasserin aut Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Acute type A aortic dissection (AAAD) is considered a fatal disease which requires an emergent surgical intervention. This study focuses onthe neurological outcome after surgical repair in cases of AAAD in comparison between elderly and young patients. Methods: a retrospective analysis of 368 consecutive patients who underwent emergency surgery of ascending aorta in moderate hypothermic circulatory arrest (MHCA) (20–24 °C) and antegrade cerebral perfusion after AAAD between 2001 and 2016. Patients were divided into two groups: those aged 75 years and older (68 (18.5%)) and those younger than 75 years (300 (81.5%)). Results: Comparing both groups, average age was 79.0 ± 3.2 vs. 59.2 ± 10.7 years (<i<p</i< < 0.001); female gender represents 58.8% of elderly patients vs. 28.7% in younger patients (<i<p</i< < 0.001). Intraoperatively, cardiopulmonary bypass time (155 min (131; 187) vs. 171 min (137; 220); <i<p</i< = 0.012), cross-clamping time (79 min (60; 105) vs. 93 min (71; 134); <i<p</i< = 0.001] and circulatory arrest time (29 min (22; 40) vs. 33 min (26; 49); <i<p</i< = 0.011) were significantly shorter in elderly than younger group. Postoperatively, there was no significant difference in delirium (11.8% vs. 20.5%; <i<p</i< = 0.0968) or stroke (11.8% vs. 16.1%; <i<p</i< = 0.369). The 30-day mortality was satisfactory for both groups but significantly higher in the elderly group (27.9% vs. 14.3%; <i<p</i< = 0.007). Conclusion: The current study concluded that surgical treatment of AAAD in elderly patients can be applied safely without increasing risk of neurological complication. However, minimizing operation time may help limit the occurrence of postoperative neurological complication. acute type A aortic dissection moderate hypothermic circulatory arrest neurological complication in elderly after type A aortic dissection Medicine R Michael Salib verfasserin aut Christine Friedrich verfasserin aut Mostafa Salem verfasserin aut Thomas Puehler verfasserin aut Jan Schoettler verfasserin aut Felix Schoeneich verfasserin aut Jochen Cremer verfasserin aut Assad Haneya verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 10(2021), 8, p 1643 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:10 year:2021 number:8, p 1643 https://doi.org/10.3390/jcm10081643 kostenfrei https://doaj.org/article/17994e0eb72a43969a3075ffed32b425 kostenfrei https://www.mdpi.com/2077-0383/10/8/1643 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 8, p 1643
allfields_unstemmed	10.3390/jcm10081643 doi (DE-627)DOAJ016780345 (DE-599)DOAJ17994e0eb72a43969a3075ffed32b425 DE-627 ger DE-627 rakwb eng Mohamed Salem verfasserin aut Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Acute type A aortic dissection (AAAD) is considered a fatal disease which requires an emergent surgical intervention. This study focuses onthe neurological outcome after surgical repair in cases of AAAD in comparison between elderly and young patients. Methods: a retrospective analysis of 368 consecutive patients who underwent emergency surgery of ascending aorta in moderate hypothermic circulatory arrest (MHCA) (20–24 °C) and antegrade cerebral perfusion after AAAD between 2001 and 2016. Patients were divided into two groups: those aged 75 years and older (68 (18.5%)) and those younger than 75 years (300 (81.5%)). Results: Comparing both groups, average age was 79.0 ± 3.2 vs. 59.2 ± 10.7 years (<i<p</i< < 0.001); female gender represents 58.8% of elderly patients vs. 28.7% in younger patients (<i<p</i< < 0.001). Intraoperatively, cardiopulmonary bypass time (155 min (131; 187) vs. 171 min (137; 220); <i<p</i< = 0.012), cross-clamping time (79 min (60; 105) vs. 93 min (71; 134); <i<p</i< = 0.001] and circulatory arrest time (29 min (22; 40) vs. 33 min (26; 49); <i<p</i< = 0.011) were significantly shorter in elderly than younger group. Postoperatively, there was no significant difference in delirium (11.8% vs. 20.5%; <i<p</i< = 0.0968) or stroke (11.8% vs. 16.1%; <i<p</i< = 0.369). The 30-day mortality was satisfactory for both groups but significantly higher in the elderly group (27.9% vs. 14.3%; <i<p</i< = 0.007). Conclusion: The current study concluded that surgical treatment of AAAD in elderly patients can be applied safely without increasing risk of neurological complication. However, minimizing operation time may help limit the occurrence of postoperative neurological complication. acute type A aortic dissection moderate hypothermic circulatory arrest neurological complication in elderly after type A aortic dissection Medicine R Michael Salib verfasserin aut Christine Friedrich verfasserin aut Mostafa Salem verfasserin aut Thomas Puehler verfasserin aut Jan Schoettler verfasserin aut Felix Schoeneich verfasserin aut Jochen Cremer verfasserin aut Assad Haneya verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 10(2021), 8, p 1643 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:10 year:2021 number:8, p 1643 https://doi.org/10.3390/jcm10081643 kostenfrei https://doaj.org/article/17994e0eb72a43969a3075ffed32b425 kostenfrei https://www.mdpi.com/2077-0383/10/8/1643 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 8, p 1643
allfieldsGer	10.3390/jcm10081643 doi (DE-627)DOAJ016780345 (DE-599)DOAJ17994e0eb72a43969a3075ffed32b425 DE-627 ger DE-627 rakwb eng Mohamed Salem verfasserin aut Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Acute type A aortic dissection (AAAD) is considered a fatal disease which requires an emergent surgical intervention. This study focuses onthe neurological outcome after surgical repair in cases of AAAD in comparison between elderly and young patients. Methods: a retrospective analysis of 368 consecutive patients who underwent emergency surgery of ascending aorta in moderate hypothermic circulatory arrest (MHCA) (20–24 °C) and antegrade cerebral perfusion after AAAD between 2001 and 2016. Patients were divided into two groups: those aged 75 years and older (68 (18.5%)) and those younger than 75 years (300 (81.5%)). Results: Comparing both groups, average age was 79.0 ± 3.2 vs. 59.2 ± 10.7 years (<i<p</i< < 0.001); female gender represents 58.8% of elderly patients vs. 28.7% in younger patients (<i<p</i< < 0.001). Intraoperatively, cardiopulmonary bypass time (155 min (131; 187) vs. 171 min (137; 220); <i<p</i< = 0.012), cross-clamping time (79 min (60; 105) vs. 93 min (71; 134); <i<p</i< = 0.001] and circulatory arrest time (29 min (22; 40) vs. 33 min (26; 49); <i<p</i< = 0.011) were significantly shorter in elderly than younger group. Postoperatively, there was no significant difference in delirium (11.8% vs. 20.5%; <i<p</i< = 0.0968) or stroke (11.8% vs. 16.1%; <i<p</i< = 0.369). The 30-day mortality was satisfactory for both groups but significantly higher in the elderly group (27.9% vs. 14.3%; <i<p</i< = 0.007). Conclusion: The current study concluded that surgical treatment of AAAD in elderly patients can be applied safely without increasing risk of neurological complication. However, minimizing operation time may help limit the occurrence of postoperative neurological complication. acute type A aortic dissection moderate hypothermic circulatory arrest neurological complication in elderly after type A aortic dissection Medicine R Michael Salib verfasserin aut Christine Friedrich verfasserin aut Mostafa Salem verfasserin aut Thomas Puehler verfasserin aut Jan Schoettler verfasserin aut Felix Schoeneich verfasserin aut Jochen Cremer verfasserin aut Assad Haneya verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 10(2021), 8, p 1643 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:10 year:2021 number:8, p 1643 https://doi.org/10.3390/jcm10081643 kostenfrei https://doaj.org/article/17994e0eb72a43969a3075ffed32b425 kostenfrei https://www.mdpi.com/2077-0383/10/8/1643 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 8, p 1643
allfieldsSound	10.3390/jcm10081643 doi (DE-627)DOAJ016780345 (DE-599)DOAJ17994e0eb72a43969a3075ffed32b425 DE-627 ger DE-627 rakwb eng Mohamed Salem verfasserin aut Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Acute type A aortic dissection (AAAD) is considered a fatal disease which requires an emergent surgical intervention. This study focuses onthe neurological outcome after surgical repair in cases of AAAD in comparison between elderly and young patients. Methods: a retrospective analysis of 368 consecutive patients who underwent emergency surgery of ascending aorta in moderate hypothermic circulatory arrest (MHCA) (20–24 °C) and antegrade cerebral perfusion after AAAD between 2001 and 2016. Patients were divided into two groups: those aged 75 years and older (68 (18.5%)) and those younger than 75 years (300 (81.5%)). Results: Comparing both groups, average age was 79.0 ± 3.2 vs. 59.2 ± 10.7 years (<i<p</i< < 0.001); female gender represents 58.8% of elderly patients vs. 28.7% in younger patients (<i<p</i< < 0.001). Intraoperatively, cardiopulmonary bypass time (155 min (131; 187) vs. 171 min (137; 220); <i<p</i< = 0.012), cross-clamping time (79 min (60; 105) vs. 93 min (71; 134); <i<p</i< = 0.001] and circulatory arrest time (29 min (22; 40) vs. 33 min (26; 49); <i<p</i< = 0.011) were significantly shorter in elderly than younger group. Postoperatively, there was no significant difference in delirium (11.8% vs. 20.5%; <i<p</i< = 0.0968) or stroke (11.8% vs. 16.1%; <i<p</i< = 0.369). The 30-day mortality was satisfactory for both groups but significantly higher in the elderly group (27.9% vs. 14.3%; <i<p</i< = 0.007). Conclusion: The current study concluded that surgical treatment of AAAD in elderly patients can be applied safely without increasing risk of neurological complication. However, minimizing operation time may help limit the occurrence of postoperative neurological complication. acute type A aortic dissection moderate hypothermic circulatory arrest neurological complication in elderly after type A aortic dissection Medicine R Michael Salib verfasserin aut Christine Friedrich verfasserin aut Mostafa Salem verfasserin aut Thomas Puehler verfasserin aut Jan Schoettler verfasserin aut Felix Schoeneich verfasserin aut Jochen Cremer verfasserin aut Assad Haneya verfasserin aut In Journal of Clinical Medicine MDPI AG, 2013 10(2021), 8, p 1643 (DE-627)718632478 (DE-600)2662592-1 20770383 nnns volume:10 year:2021 number:8, p 1643 https://doi.org/10.3390/jcm10081643 kostenfrei https://doaj.org/article/17994e0eb72a43969a3075ffed32b425 kostenfrei https://www.mdpi.com/2077-0383/10/8/1643 kostenfrei https://doaj.org/toc/2077-0383 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2021 8, p 1643
language	English
source	In Journal of Clinical Medicine 10(2021), 8, p 1643 volume:10 year:2021 number:8, p 1643
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authorswithroles_txt_mv	Mohamed Salem @@aut@@ Michael Salib @@aut@@ Christine Friedrich @@aut@@ Mostafa Salem @@aut@@ Thomas Puehler @@aut@@ Jan Schoettler @@aut@@ Felix Schoeneich @@aut@@ Jochen Cremer @@aut@@ Assad Haneya @@aut@@
publishDateDaySort_date	2021-01-01T00:00:00Z
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author	Mohamed Salem
spellingShingle	Mohamed Salem misc acute type A aortic dissection misc moderate hypothermic circulatory arrest misc neurological complication in elderly after type A aortic dissection misc Medicine misc R Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection
authorStr	Mohamed Salem
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issn	20770383
topic_title	Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection acute type A aortic dissection moderate hypothermic circulatory arrest neurological complication in elderly after type A aortic dissection
topic	misc acute type A aortic dissection misc moderate hypothermic circulatory arrest misc neurological complication in elderly after type A aortic dissection misc Medicine misc R
topic_unstemmed	misc acute type A aortic dissection misc moderate hypothermic circulatory arrest misc neurological complication in elderly after type A aortic dissection misc Medicine misc R
topic_browse	misc acute type A aortic dissection misc moderate hypothermic circulatory arrest misc neurological complication in elderly after type A aortic dissection misc Medicine misc R
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title	Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection
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title_full	Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection
author_sort	Mohamed Salem
journal	Journal of Clinical Medicine
journalStr	Journal of Clinical Medicine
lang_code	eng
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author_browse	Mohamed Salem Michael Salib Christine Friedrich Mostafa Salem Thomas Puehler Jan Schoettler Felix Schoeneich Jochen Cremer Assad Haneya
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title_sort	influence of age on postoperative neurological outcomes after surgery of acute type a aortic dissection
title_auth	Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection
abstract	Background: Acute type A aortic dissection (AAAD) is considered a fatal disease which requires an emergent surgical intervention. This study focuses onthe neurological outcome after surgical repair in cases of AAAD in comparison between elderly and young patients. Methods: a retrospective analysis of 368 consecutive patients who underwent emergency surgery of ascending aorta in moderate hypothermic circulatory arrest (MHCA) (20–24 °C) and antegrade cerebral perfusion after AAAD between 2001 and 2016. Patients were divided into two groups: those aged 75 years and older (68 (18.5%)) and those younger than 75 years (300 (81.5%)). Results: Comparing both groups, average age was 79.0 ± 3.2 vs. 59.2 ± 10.7 years (<i<p</i< < 0.001); female gender represents 58.8% of elderly patients vs. 28.7% in younger patients (<i<p</i< < 0.001). Intraoperatively, cardiopulmonary bypass time (155 min (131; 187) vs. 171 min (137; 220); <i<p</i< = 0.012), cross-clamping time (79 min (60; 105) vs. 93 min (71; 134); <i<p</i< = 0.001] and circulatory arrest time (29 min (22; 40) vs. 33 min (26; 49); <i<p</i< = 0.011) were significantly shorter in elderly than younger group. Postoperatively, there was no significant difference in delirium (11.8% vs. 20.5%; <i<p</i< = 0.0968) or stroke (11.8% vs. 16.1%; <i<p</i< = 0.369). The 30-day mortality was satisfactory for both groups but significantly higher in the elderly group (27.9% vs. 14.3%; <i<p</i< = 0.007). Conclusion: The current study concluded that surgical treatment of AAAD in elderly patients can be applied safely without increasing risk of neurological complication. However, minimizing operation time may help limit the occurrence of postoperative neurological complication.
abstractGer	Background: Acute type A aortic dissection (AAAD) is considered a fatal disease which requires an emergent surgical intervention. This study focuses onthe neurological outcome after surgical repair in cases of AAAD in comparison between elderly and young patients. Methods: a retrospective analysis of 368 consecutive patients who underwent emergency surgery of ascending aorta in moderate hypothermic circulatory arrest (MHCA) (20–24 °C) and antegrade cerebral perfusion after AAAD between 2001 and 2016. Patients were divided into two groups: those aged 75 years and older (68 (18.5%)) and those younger than 75 years (300 (81.5%)). Results: Comparing both groups, average age was 79.0 ± 3.2 vs. 59.2 ± 10.7 years (<i<p</i< < 0.001); female gender represents 58.8% of elderly patients vs. 28.7% in younger patients (<i<p</i< < 0.001). Intraoperatively, cardiopulmonary bypass time (155 min (131; 187) vs. 171 min (137; 220); <i<p</i< = 0.012), cross-clamping time (79 min (60; 105) vs. 93 min (71; 134); <i<p</i< = 0.001] and circulatory arrest time (29 min (22; 40) vs. 33 min (26; 49); <i<p</i< = 0.011) were significantly shorter in elderly than younger group. Postoperatively, there was no significant difference in delirium (11.8% vs. 20.5%; <i<p</i< = 0.0968) or stroke (11.8% vs. 16.1%; <i<p</i< = 0.369). The 30-day mortality was satisfactory for both groups but significantly higher in the elderly group (27.9% vs. 14.3%; <i<p</i< = 0.007). Conclusion: The current study concluded that surgical treatment of AAAD in elderly patients can be applied safely without increasing risk of neurological complication. However, minimizing operation time may help limit the occurrence of postoperative neurological complication.
abstract_unstemmed	Background: Acute type A aortic dissection (AAAD) is considered a fatal disease which requires an emergent surgical intervention. This study focuses onthe neurological outcome after surgical repair in cases of AAAD in comparison between elderly and young patients. Methods: a retrospective analysis of 368 consecutive patients who underwent emergency surgery of ascending aorta in moderate hypothermic circulatory arrest (MHCA) (20–24 °C) and antegrade cerebral perfusion after AAAD between 2001 and 2016. Patients were divided into two groups: those aged 75 years and older (68 (18.5%)) and those younger than 75 years (300 (81.5%)). Results: Comparing both groups, average age was 79.0 ± 3.2 vs. 59.2 ± 10.7 years (<i<p</i< < 0.001); female gender represents 58.8% of elderly patients vs. 28.7% in younger patients (<i<p</i< < 0.001). Intraoperatively, cardiopulmonary bypass time (155 min (131; 187) vs. 171 min (137; 220); <i<p</i< = 0.012), cross-clamping time (79 min (60; 105) vs. 93 min (71; 134); <i<p</i< = 0.001] and circulatory arrest time (29 min (22; 40) vs. 33 min (26; 49); <i<p</i< = 0.011) were significantly shorter in elderly than younger group. Postoperatively, there was no significant difference in delirium (11.8% vs. 20.5%; <i<p</i< = 0.0968) or stroke (11.8% vs. 16.1%; <i<p</i< = 0.369). The 30-day mortality was satisfactory for both groups but significantly higher in the elderly group (27.9% vs. 14.3%; <i<p</i< = 0.007). Conclusion: The current study concluded that surgical treatment of AAAD in elderly patients can be applied safely without increasing risk of neurological complication. However, minimizing operation time may help limit the occurrence of postoperative neurological complication.
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title_short	Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection
url	https://doi.org/10.3390/jcm10081643 https://doaj.org/article/17994e0eb72a43969a3075ffed32b425 https://www.mdpi.com/2077-0383/10/8/1643 https://doaj.org/toc/2077-0383
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author2	Michael Salib Christine Friedrich Mostafa Salem Thomas Puehler Jan Schoettler Felix Schoeneich Jochen Cremer Assad Haneya
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up_date	2024-07-03T22:55:51.474Z
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