Sari Sezai, Sener Kemal, Calis Mustafa, Polat Mustafa, Kaya Adem, Yolcu Sadiye
Sezai Sari, Adana City Research & Education Hospital Deptartment of Emergency Medicine, Adana/Turkey.
Kemal Sener, Adana City Research & Education Hospital Deptartment of Emergency Medicine, Adana/Turkey.
Pak J Med Sci. 2021 Mar-Apr;37(2):339-344. doi: 10.12669/pjms.37.2.2877.
In this study we aimed to determine the prediction level of admission diastolic blood pressure (DBP) on the prognosis and mortality in aortic dissection patients over 65 years old and under 65 years old.
We included 72 patients in this retrospective study and study groups were divided into two groups according to 65 age. Demographic data, dissection type (Stanford A-B), DBP, systolic blood pressure (SBP), mean arteriel pressure (MAP), heart rate (/min) main complaints, preoperative length of stay, hospitalisation clinic (clinic/intensive care unit), length of hospitaliisation, complications during hospitalisation (renal failure etc..) and the outcome (death/dischargement) results were noted. Preoperative lenth of stay, hospitalisation length, outcome and complications were compared between groups according to SBP, DBP, MAP and heart rate.
Mean blood pressure values of the Stanford type B patients over 65 years old were higher than the other group (p<0.05). Fifty percent of patients under 65 years old were discharged but this ratio was 26.9% in the elder group. DBP was positively correlated with preoperative length of stay and hospitalisation length and negatively correlated with mortality. DBP under 65 mmHg was significantly related with high mortality (p<0.05). When the age and presentation time heart rate is added to each other, the values over 142 were significantly related with high mortality (p<0.05).
The presentation time vital signs especially the DBP may be helpful for emergency clinicians to predict the prognosis and outcome in aortic dissection patients which has high mortality ratio in patients over 65 years of age.
在本研究中，我们旨在确定入院舒张压（DBP）对65岁及以上和65岁以下主动脉夹层患者的预后及死亡率的预测水平。
我们纳入了72例患者进行这项回顾性研究，并根据年龄65岁将研究组分为两组。记录人口统计学数据、夹层类型（斯坦福A - B型）、DBP、收缩压（SBP）、平均动脉压（MAP）、心率（次/分钟）、主要症状、术前住院时间、住院科室（普通科室/重症监护室）、住院时长、住院期间的并发症（肾衰竭等）以及结局（死亡/出院）结果。根据SBP、DBP、MAP和心率比较两组之间的术前住院时间、住院时长、结局及并发症。
65岁以上斯坦福B型患者的平均血压值高于另一组（p<0.05）。65岁以下患者中有50%出院，但老年组这一比例为26.9%。DBP与术前住院时间和住院时长呈正相关，与死亡率呈负相关。DBP低于65 mmHg与高死亡率显著相关（p<0.05）。当年龄和就诊时心率相加时，值超过142与高死亡率显著相关（p<0.05）。
就诊时的生命体征尤其是DBP可能有助于急诊医生预测主动脉夹层患者的预后及结局，65岁以上患者的死亡率较高。
