Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA.
Creighton University School of Medicine, Omaha, NE, USA.
Sci Rep. 2020 Mar 13;10(1):4723. doi: 10.1038/s41598-020-61717-5.
Triggering events for acute aortic dissections are incompletely understood. We sought to investigate whether there is an association between admission for acute type A aortic dissection (ATAAD) to the University of Michigan Medical Center and the reported annual influenza activity by the Michigan Department of Health and Human Services. From 1996-2019 we had 758 patients admitted for ATAAD with 3.1 admissions per month during November-March and 2.5 admissions per month during April-October (p = 0.01). Influenza reporting data by the Michigan Department of Health and Human Services became available in 2009. ATAAD admissions for the period 2009-2019 (n = 455) were 4.8 cases/month during peak influenza months compared to 3.5 cases/month during non-peak influenza months (p = 0.001). ATAAD patients admitted during influenza season had increased in-hospital mortality (11.0% vs. 5.8%, p = 0.024) and increased 30-day mortality (9.7 vs. 5.4%, p = 0.048). The results point to higher admission rates for ATAAD during months with above average influenza rates. Future studies need to investigate whether influenza virus infection affects susceptibility for aortic dissection, and whether this risk can be attenuated with the annual influenza vaccine in this patient population.
急性主动脉夹层的触发事件尚不完全清楚。我们试图调查密歇根大学医疗中心急性 A 型主动脉夹层（ATAAD）的入院率与密歇根州卫生与公众服务部报告的年度流感活动之间是否存在关联。1996 年至 2019 年，我们有 758 例 ATAAD 患者入院，11 月至 3 月期间每月有 3.1 例入院，4 月至 10 月期间每月有 2.5 例入院（p=0.01）。密歇根州卫生与公众服务部的流感报告数据于 2009 年开始可用。2009 年至 2019 年（n=455）期间的 ATAAD 入院病例中，流感高峰期每月有 4.8 例，而非高峰期每月有 3.5 例（p=0.001）。在流感季节入院的 ATAAD 患者的院内死亡率（11.0% vs. 5.8%，p=0.024）和 30 天死亡率（9.7% vs. 5.4%，p=0.048）均升高。结果表明，流感发病率较高的月份 ATAAD 的入院率更高。未来的研究需要调查流感病毒感染是否会影响主动脉夹层的易感性，以及在该患者人群中，这种风险是否可以通过每年接种流感疫苗来降低。
