| Objectives: Most Acute Aortic Dissection(AAD)patients present recurrent pains,which elevate blood pressure and risks of aortic dissection rupture,yet few studies investigate the relationship between recurrent pains and mortality in patients.In this study,we aim to investigate the prevalence of recurrent pain and its relationship with in-hospital mortality in AAD patients.Methods: Between January-2011 and March-2016,234 AAD patients were selected from the First Affiliated Hospital of Xinjiang Medical University.Recurrent pains were defined as those with a mean of VAS>3,within 48 hours following hospital admission or before the emergency operation.Then patients with and without recurrent pains,were divided to Group I(risk group,)and Group II(control group)respectively in Stanford type A AAD and Stanford type B AAD patients.Our primary outcome was in-hospital mortality.Results: The incidence of recurrent pains was 24.4%in AAD patients.Incidence of recurrent pain was higher in Stanford type A AAD patients than Stanford type B AAD patients(48.9%vs.9.6%).Over all in-hospital mortality was 25.6%.Stanford type A AAD had a higher in-hospital mortality than Stanford type B AAD patients(47.7%vs.12.3%).Group-I had significantly higher in-hospital mortality than Group-II(type A: 79.1%vs.17.8%;type B: 57.1%vs.7.6%,all P<0.001),as was the case with medical management patients(type A: 72.1%vs.13.3%;type B: 35.7%vs.2.3%,all P<0.001).Multivariate Logistic Regression Analysis showed that use of one drug alone and waist pain were the predictive factors for recurrent pain in Stanford type A AAD and Stanford type A AAB patients,respectively(OR 3.686,95%CI: 1.103~12.316,P=0.034 and OR 14.010,95%CI: 2.481~79.103,P=0.003).Recurrent pains were the risk factor(type A: OR 11.096,95%CI: 3.057~40.280,P<0.001;type B: OR 14.412,95%CI: 3.662~56.723,P<0.001),while invasive interventions were the protective factor(type A: OR 0.133,95%CI: 0.035~0.507,P<0.001;type B: OR 0.334,95%CI: 0.120~0.929,P=0.036)for in-hospital mortality in AAD patients.Conclusion: Approximately,one-fourth of AAD patients presented recurrent pains,which might increase in-hospital mortality.Thus,interventional strategies at early stages are important. |
