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RESEARCH PRODUCT
Penn classification in acute aortic dissection patients
Calogera PisanoCarmela Rita BalistreriFederico TorrettaVeronica CapuccioAlberto AllegraVincenzo ArganoGiovanni Ruvolosubject
MaleType A dissection Stanford classification DeBakey classification Penn classificationMyocardial IschemiaRisk AssessmentOutcome Assessment (Health Care)Outcome Assessment Health CarePreoperative CareStanford classificationHumansSettore MED/05 - Patologia ClinicaHospital MortalityAgedType A dissection – Stanford classification – DeBakey classification – Penn classificationPenn classificationSettore MED/23 - Chirurgia CardiacaShockGeneral MedicineMiddle AgedPrognosisAneurysmDeBakey classification; Penn classification; Stanford classification; Type A dissection; Aged; Female; Hospital Mortality; Humans; Italy; Male; Middle Aged; Myocardial Ischemia; Outcome Assessment (Health Care); Preoperative Care; Prognosis; Risk Assessment; Shock; Vascular Surgical Procedures; Aneurysm Dissecting; Aortic AneurysmAortic AneurysmSettore MED/23Aortic DissectionItalyDeBakey classificationType A dissectionFemaleCardiology and Cardiovascular MedicineVascular Surgical ProceduresDissectingdescription
Objective The objective of this study was to evaluate the effectiveness of the Penn classification in predicting in-hospital mortality after surgery in acute type A aortic dissection patients. Methods We evaluated 58 patients (42 men and 16 women; mean age 62.17 ± 10.6 years) who underwent emergency surgery for acute type A aortic dissection between September 2003 and June 2010 in our department. We investigated the correlation between the pre-operative malperfusion and in-hospital outcome after surgery. Results Twenty-eight patients (48%) were Penn class Aa (absence of branch vessel malperfusion or circulatory collapse), 11 (19%) were Penn class Ab (branch vessel malperfusion with ischaemia), 5 (9%) were Penn class Ac (circulatory collapse with or without cardiac involvement) and 14 (24%) were Penn class Abc (both branch vessel malperfusion and circulatory collapse). The number of patients with localized or generalized ischaemia or both, Penn class non-Aa, was 30 (52%). In-hospital mortality was 24%. In-hospital mortality was significantly higher in Penn class Abc and Penn class non-Aa. Intensive unit care stay, hospital ward stay and overall hospital stay was longer in Penn class non-Aa vs Penn class Aa. De Bakey type I dissection and type II diabetes mellitus were associated with in-hospital mortality. Conclusion Preoperative malperfusion is important for the evaluation of patients with acute aortic type A dissection. The Penn classification is a simple and quick method to apply and predict in-hospital mortality and outcomes. Keywords Type A dissection – Stanford classification – DeBakey classification – Penn classification.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2016-01-01 |