ArticleAnnals of cardiothoracic surgery2023
Sex differences in long-term outcomes following surgery for acute type A aortic dissection: a systematic review and meta-analysis.
Article in Annals of cardiothoracic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Acute type A aortic dissection in patients with non-prior cardiac surgery vs. prior cardiac surgery: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2024Pooled it
- Evolving Demographics and Outcomes in Surgically Treated Acute Type A Aortic Dissection: A Fifteen-Year Regional Experience.Medicina (Kaunas, Lithuania) · 2025Article
- Patient Characteristics Associated With Outcomes After General Anaesthesia in Denmark: A Nationwide Observational Study.Acta anaesthesiologica Scandinavica · 2025Observational
- Global, regional, and national trends in the epidemiology of aortic aneurysms among women of childbearing age, 1990-2021, with predictions through 2036.BMC public health · 2025Article
- The relationship of sex and aortic diameter at the time of acute type A aortic dissection.JTCVS open · 2024Article
- Sex Differences in Outcomes After Elective and Acute Aortic Surgery-A Single-Centre Experience over the Last Two Decades.Journal of clinical medicine · 2024Article
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Authors and funding
7 authors.
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Abstract
Background: Recent reports on sex differences in long-term outcomes after surgery for acute type A aortic dissection (ATAAD) are conflicting. We aimed to aggregate updated data on long-term survival and reoperation stratified by sex. Methods: A literature search was conducted using Medline, Embase, and Cochrane Central. Studies reporting sex-stratified long-term survival and/or reoperation following surgery for ATAAD between January 1, 2000, to March 15, 2023 were included. Preoperative characteristics, intraoperative variables, and early perioperative outcomes were meta-analyzed using a random effects model and pooled risk ratio (RR) with men as the reference group. Individual patient-level data for long-term outcomes was reconstructed to generate sex-specific pooled Kaplan-Meier curves to assess long-term survival and freedom from reoperation. Results: A total of 15 studies with 7,608 male and 3,989 female patients were included in this analysis. Female patients were older, had higher rates of hypertension, and had less previous cardiac surgery. Intraoperatively, women received less extensive repairs with lower rates of aortic valve replacement and total arch replacement, and higher rates of hemiarch replacement. There were no sex differences for in-hospital/30-day mortality [risk ratio (RR), 1.18; 95% confidence interval (CI): 0.96, 1.45; P=0.12], stroke (RR, 1.07; 95% CI: 0.90, 1.28; P=0.46), and early reoperation (RR, 0.90; 95% CI: 0.75, 1.09; P=0.28). Female patients had lower long-term survival overall (P<0.001) and amongst survivors at 1-year (P=0.014). Overall survival at 5-year was 82.4% in men and 78.1% in women, and at 10-year was 68.1% for men and 63.4% in women. Male patients had higher rates of long-term reoperation (P<0.001). Freedom for reoperation at 5-year was 88.4% in men Conclusions: Though perioperative early outcomes have equalized between the sexes following surgery for ATAAD, differences remain in long-term survival and reoperation.
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