Long-term sex-based outcomes after surgery for acute type A aortic dissection: Meta-analysis of reconstructed time-to-event data

The influence of sex on outcomes of surgery for acute type A aortic dissection remains incompletely characterized. We sought to evaluate post-procedural survival in the follow-up of females versus males. We carried out a systematic review with meta-analysis of Kaplan–Meier-derived time-to-event data...

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Published in:The American journal of surgery 2024-02, Vol.228, p.159-164
Main Authors: Sá, Michel Pompeu, Tasoudis, Panagiotis, Jacquemyn, Xander, Ahmad, Danial, Diaz-Castrillón, Carlos E., Brown, James A., Yousef, Sarah, Zhang, Dongning, Dufendach, Keith, Serna-Gallegos, Derek, Sultan, Ibrahim
Format: Article
Language:English
Subjects:
Acute Disease
Age
Aorta
Aortic Aneurysm, Thoracic - mortality
Aortic Aneurysm, Thoracic - surgery
Aortic dissection
Aortic Dissection - mortality
Aortic Dissection - surgery
Aortic valve
Cardiac surgical procedures
Cardiovascular disease
Cardiovascular surgical procedures
Clinical trials
Connective tissue
Connective tissues
Coronary artery disease
Dissection
Female
Females
Frailty
Heart diseases
Heart valves
Humans
Male
Males
Meta-analysis
Mortality
Regression analysis
Sex
Sex Factors
Surgery
Survival
Survival analysis
Systematic review
Thoracic aorta
Treatment Outcome
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Summary:The influence of sex on outcomes of surgery for acute type A aortic dissection remains incompletely characterized. We sought to evaluate post-procedural survival in the follow-up of females versus males. We carried out a systematic review with meta-analysis of Kaplan–Meier-derived time-to-event data from studies published by June 2023 in the following databases: PubMed/MEDLINE, EMBASE, Web of Science and CENTRAL/CCTR (Cochrane Controlled Trials Register). Twelve studies met our eligibility criteria, including 11,696 patients (3753 females; 7943 males). The mean age ranged from 41.2 to 72.6 years with low prevalence of bicuspid aortic valve (ranging from 0.0% to 12.0%) and connective tissue disorders (ranging from 0.8% to 7.3%). We found a considerable prevalence of coronary artery disease (ranging from 12.1% to 21.1%) and malperfusion (ranging from 20.0% to 46.3%). At 10 years, females undergoing surgery had a significantly higher risk of all-cause mortality compared with males (HR 1.25, 95%CI 1.14–1.38, P ​
ISSN:0002-9610
1879-1883
1879-1883
DOI:10.1016/j.amjsurg.2023.09.012