Non-O blood group is associated with lower risk of in-hospital mortality in non-surgically managed patients with type A
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RESEARCH ARTICLE
Open Access
Non‑O blood group is associated with lower risk of in‑hospital mortality in non‑surgically managed patients with type A aortic dissection Song Huang1†, Yequn Chen1,5†, Zhaotao Huang1,2†, Shiwan Wu1, Nianling Xiong1,2, Xiru Huang1,2, Xin Wang1, Chang Chen1, Bin Wang1, Weiping Li1,4, Liangli Hong1, Shu Ye1,2,3* and Xuerui Tan1,2,5*
Abstract Background: The association between different ABO blood groups and mortality of aortic dissection (AD) remains controversial. This study aimed to examine whether different ABO blood groups affect the prognosis of AD. Methods: Demographic and clinical data were collected from 877 patients diagnosed with AD from 2015 to 2019 in the First Affiliated Hospital of Shantou University Medical College. The association between in-hospital mortality of AD patients and ABO blood group was analyzed using Cox proportional hazards regression models. Results: This retrograde cohort study demonstrated that for 877 patients, male gender, non-O blood group, Stanford type B AD (TBAD), higher presenting systolic and diastolic blood pressure, and being a recipient of aortic arch replacement surgery (surgery) or endovascular stent-graft implantation (stent-graft) were associated with decreased in-hospital mortality of AD. In Cox proportional hazards models, non-O blood group was associated with lower risk of early mortality regardless of adjustment (HR = 0.668, 95% confidence interval [CI] 0.473–0.944 before adjustment, HR = 0.662, 95% CI 0.468–0.935 after adjustment for age and sex, and HR = 0.641, 95% CI 0.453–0.906 after adjustment for AD types, SBP and surgery). Further analyses revealed that for patients diagnosed with type A AD (TAAD), non-O blood group renders a significant 34.3% decrease in the risk of in-hospital mortality compared with blood group O. Specifically, this difference in mortality risk was found among TAAD patients who did not undergo surgery (HR = 0.579, 95% CI 0.377–0.889), rather than those who did. There was no significant difference in early mortality for patients with TBAD, whether or not stent-grafts were implanted. Conclusions: Non-O blood type decreases the risk of in-hospital mortality, especially for TAAD, in AD patients without surgical intervention. More attention must be paid to blood type O TAAD patients without surgical interventions, and early surgical intervention may be an effective means to decrease in-hospital mortality of TAAD. Keywords: Aortic dissection, Mortality, ABO blood groups
*Correspondence: [email protected]; [email protected] † Song Huang, Yequn Chen and Zhaotao Huang have contributed equally to this work 1 The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China 2 Shantou University Medical College, Shantou 515041, Guangdong, China Full list of author information is available at the end of the article
Background Aortic dissection (AD) is a life-threatening emergency with an overall mortality of 27.4% [1]. It is well established that the outcome of AD is associat
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