Usefulness of the initial noninvasive imaging study to predict the adverse outcomes in the medical treatment of acute type A aortic intramural hematoma

Jong Min Song, Hyun Sook Kim, Jae Kwan Song, Duk Hyun Kang, Myeong Ki Hong, Jae Joong Kim, Seong Wook Park, Seung Jung Park, Tae Hwan Lim, Meong Gun Song

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Abstract

Background - There have been contradictory reports about the outcomes of medically treated patients with type A aortic intramural hematoma (AIH), and it is not certain if the initial noninvasive imaging studies can provide any useful predictors for the adverse outcomes. Methods and Results - Imaging studies and clinical outcomes of 25 consecutive patients with type A AIH who initially received medical treatment were analyzed retrospectively. Adverse outcomes (death, surgery, and development of dissection) occurred in 9 patients (group A), whereas the other 16 patients showed an uneventful course (group B). The hematoma thickness (14±4 versus 8±4 mm, P<0.005) and hematoma are (988±316 versus 555±352 mm2, P<0.01) in the imaging study performed ≤48 hours after onset of initial symptoms were significantly larger in group A; maximal aortic diameter (53±6 versus 48±8 mm, P=0.10) and aortic cross-sectional area (2247±501 versus 1809±626 mm2, P=0.09) were also somewhat larger in group A. The hematoma thickness was the only independent predictor for the adverse outcomes by stepwise multiple logistic regression analysis (odds ratio 1.41, 95% confidence interval 1.07 to 1.86, P<0.05). Hematoma thickness ≥11 mm predicted the adverse outcomes with sensitivity 89% and specificity 69%. No one with hemodynamically stable initial condition and the hematoma thickness <11 mm experienced the adverse outcomes. Conclusion - Noninvasive imaging study provides important prognostic information in the medical treatment of acute type A AIH, and initial hematoma thickness seems to be the best index for predicting adverse clinical outcome.

Original languageEnglish
Pages (from-to)II324-II328
JournalCirculation
Volume108
Issue number10 SUPPL.
Publication statusPublished - 2003 Sep 9

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Hematoma
Therapeutics
Dissection
Logistic Models
Odds Ratio
Regression Analysis
Outcome Assessment (Health Care)
Confidence Intervals
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Song, J. M., Kim, H. S., Song, J. K., Kang, D. H., Hong, M. K., Kim, J. J., ... Song, M. G. (2003). Usefulness of the initial noninvasive imaging study to predict the adverse outcomes in the medical treatment of acute type A aortic intramural hematoma. Circulation, 108(10 SUPPL.), II324-II328.
Song, Jong Min ; Kim, Hyun Sook ; Song, Jae Kwan ; Kang, Duk Hyun ; Hong, Myeong Ki ; Kim, Jae Joong ; Park, Seong Wook ; Park, Seung Jung ; Lim, Tae Hwan ; Song, Meong Gun. / Usefulness of the initial noninvasive imaging study to predict the adverse outcomes in the medical treatment of acute type A aortic intramural hematoma. In: Circulation. 2003 ; Vol. 108, No. 10 SUPPL. pp. II324-II328.
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abstract = "Background - There have been contradictory reports about the outcomes of medically treated patients with type A aortic intramural hematoma (AIH), and it is not certain if the initial noninvasive imaging studies can provide any useful predictors for the adverse outcomes. Methods and Results - Imaging studies and clinical outcomes of 25 consecutive patients with type A AIH who initially received medical treatment were analyzed retrospectively. Adverse outcomes (death, surgery, and development of dissection) occurred in 9 patients (group A), whereas the other 16 patients showed an uneventful course (group B). The hematoma thickness (14±4 versus 8±4 mm, P<0.005) and hematoma are (988±316 versus 555±352 mm2, P<0.01) in the imaging study performed ≤48 hours after onset of initial symptoms were significantly larger in group A; maximal aortic diameter (53±6 versus 48±8 mm, P=0.10) and aortic cross-sectional area (2247±501 versus 1809±626 mm2, P=0.09) were also somewhat larger in group A. The hematoma thickness was the only independent predictor for the adverse outcomes by stepwise multiple logistic regression analysis (odds ratio 1.41, 95{\%} confidence interval 1.07 to 1.86, P<0.05). Hematoma thickness ≥11 mm predicted the adverse outcomes with sensitivity 89{\%} and specificity 69{\%}. No one with hemodynamically stable initial condition and the hematoma thickness <11 mm experienced the adverse outcomes. Conclusion - Noninvasive imaging study provides important prognostic information in the medical treatment of acute type A AIH, and initial hematoma thickness seems to be the best index for predicting adverse clinical outcome.",
author = "Song, {Jong Min} and Kim, {Hyun Sook} and Song, {Jae Kwan} and Kang, {Duk Hyun} and Hong, {Myeong Ki} and Kim, {Jae Joong} and Park, {Seong Wook} and Park, {Seung Jung} and Lim, {Tae Hwan} and Song, {Meong Gun}",
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Song, JM, Kim, HS, Song, JK, Kang, DH, Hong, MK, Kim, JJ, Park, SW, Park, SJ, Lim, TH & Song, MG 2003, 'Usefulness of the initial noninvasive imaging study to predict the adverse outcomes in the medical treatment of acute type A aortic intramural hematoma', Circulation, vol. 108, no. 10 SUPPL., pp. II324-II328.

Usefulness of the initial noninvasive imaging study to predict the adverse outcomes in the medical treatment of acute type A aortic intramural hematoma. / Song, Jong Min; Kim, Hyun Sook; Song, Jae Kwan; Kang, Duk Hyun; Hong, Myeong Ki; Kim, Jae Joong; Park, Seong Wook; Park, Seung Jung; Lim, Tae Hwan; Song, Meong Gun.

In: Circulation, Vol. 108, No. 10 SUPPL., 09.09.2003, p. II324-II328.

Research output: Contribution to journalArticle

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T1 - Usefulness of the initial noninvasive imaging study to predict the adverse outcomes in the medical treatment of acute type A aortic intramural hematoma

AU - Song, Jong Min

AU - Kim, Hyun Sook

AU - Song, Jae Kwan

AU - Kang, Duk Hyun

AU - Hong, Myeong Ki

AU - Kim, Jae Joong

AU - Park, Seong Wook

AU - Park, Seung Jung

AU - Lim, Tae Hwan

AU - Song, Meong Gun

PY - 2003/9/9

Y1 - 2003/9/9

N2 - Background - There have been contradictory reports about the outcomes of medically treated patients with type A aortic intramural hematoma (AIH), and it is not certain if the initial noninvasive imaging studies can provide any useful predictors for the adverse outcomes. Methods and Results - Imaging studies and clinical outcomes of 25 consecutive patients with type A AIH who initially received medical treatment were analyzed retrospectively. Adverse outcomes (death, surgery, and development of dissection) occurred in 9 patients (group A), whereas the other 16 patients showed an uneventful course (group B). The hematoma thickness (14±4 versus 8±4 mm, P<0.005) and hematoma are (988±316 versus 555±352 mm2, P<0.01) in the imaging study performed ≤48 hours after onset of initial symptoms were significantly larger in group A; maximal aortic diameter (53±6 versus 48±8 mm, P=0.10) and aortic cross-sectional area (2247±501 versus 1809±626 mm2, P=0.09) were also somewhat larger in group A. The hematoma thickness was the only independent predictor for the adverse outcomes by stepwise multiple logistic regression analysis (odds ratio 1.41, 95% confidence interval 1.07 to 1.86, P<0.05). Hematoma thickness ≥11 mm predicted the adverse outcomes with sensitivity 89% and specificity 69%. No one with hemodynamically stable initial condition and the hematoma thickness <11 mm experienced the adverse outcomes. Conclusion - Noninvasive imaging study provides important prognostic information in the medical treatment of acute type A AIH, and initial hematoma thickness seems to be the best index for predicting adverse clinical outcome.

AB - Background - There have been contradictory reports about the outcomes of medically treated patients with type A aortic intramural hematoma (AIH), and it is not certain if the initial noninvasive imaging studies can provide any useful predictors for the adverse outcomes. Methods and Results - Imaging studies and clinical outcomes of 25 consecutive patients with type A AIH who initially received medical treatment were analyzed retrospectively. Adverse outcomes (death, surgery, and development of dissection) occurred in 9 patients (group A), whereas the other 16 patients showed an uneventful course (group B). The hematoma thickness (14±4 versus 8±4 mm, P<0.005) and hematoma are (988±316 versus 555±352 mm2, P<0.01) in the imaging study performed ≤48 hours after onset of initial symptoms were significantly larger in group A; maximal aortic diameter (53±6 versus 48±8 mm, P=0.10) and aortic cross-sectional area (2247±501 versus 1809±626 mm2, P=0.09) were also somewhat larger in group A. The hematoma thickness was the only independent predictor for the adverse outcomes by stepwise multiple logistic regression analysis (odds ratio 1.41, 95% confidence interval 1.07 to 1.86, P<0.05). Hematoma thickness ≥11 mm predicted the adverse outcomes with sensitivity 89% and specificity 69%. No one with hemodynamically stable initial condition and the hematoma thickness <11 mm experienced the adverse outcomes. Conclusion - Noninvasive imaging study provides important prognostic information in the medical treatment of acute type A AIH, and initial hematoma thickness seems to be the best index for predicting adverse clinical outcome.

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