Association between the environment and the development of acute aortic dissection: A nationwid study

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K19470
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
• Research Institution: Nippon Medical School
• Principal Investigator: Kato Katsuhito 日本医科大学, 医学部, 講師 (40409157)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 週末入院 / 急性大動脈解離 / スタンフォード分類 / 自然環境 / 院内死亡

Outline of Final Research Achievements

Using the JROAD-DPC database, we presented a conference and wrote a paper on the impact of weekend hospitalization on in-hospital mortality in acute aortic dissection (AAD).The total 33,706 patients for AAD hospitalized higher on weekdays compared to weekends, with an in-hospital mortality rate of 21.9%. Patients admitted on Sundays and holidays showed a significant increase in in-hospital mortality compared to weekdays. In particular, stratified analysis of the Stanford classification by site of dissection showed that only type A patients admitted on Sundays and holidays had a significant increase in in-hospital mortality.
In conclusion, our results suggest that the risk of in-hospital mortality may be higher for AAD Stanford type A patients admitted on Sundays and holidays.

Free Research Field

循環器疫学

Academic Significance and Societal Importance of the Research Achievements

急性大動脈解離の疫学研究が限られている中、全国の循環器専門施設データであるJROAD-DPCデータベースを用いて国内の急性大動脈解離の入院について網羅的に検討を行うことが可能となった。週末に入院をする急性大動脈解離、特に緊急手術など医療資源がより必要となるスタンフォードA型の急性大動脈解離では院内死亡リスクが高いことが示唆され、今後は長期予後を含めた検討や、死亡リスクが高い理由の詳細な検討が必要である。