Evidence map›Paper›PMID 39907174›Full record

ArticleANZ journal of surgery2025

Outcomes of type A aortic dissection in Australia.

Abbey Knox, Damian Gimpel, David Lance, Gregory D Rice, Gareth Crouch, Richard F Newland, Robert A Baker, Jayme S Bennetts

Abstract readMulticenter Study
In one paragraph

Article in ANZ journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Abbey KnoxCardiothoracic Surgery, Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia.ORCID 0000-0001-9234-086X
Damian GimpelCardiothoracic Surgery, Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia.
David LanceCardiothoracic Surgery, Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia.
Gregory D RiceCardiothoracic Surgery, Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia.
Gareth CrouchCardiothoracic Surgery, Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia.
Richard F NewlandCardiothoracic Surgery, Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia.
Robert A BakerCardiothoracic Surgery, Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia.
Jayme S BennettsCardiothoracic Surgery, Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWithout surgical intervention, type A aortic dissection (TAAD) carries a high risk of life-threatening complications and mortality. Due to the low incidence of aortic dissection, case numbers vary significantly between institutions. This study reports outcomes for patients undergoing surgical TAAD repair in Australia between 2001 and 2021, and the impact of institution case numbers on mortality.

methodsRetrospective multicentre cohort study using the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) data, including consecutive adult patients undergoing surgery for TAAD. Patients were divided into groups based on 30-day mortality. Secondary morbidity outcomes are reported.

resultsBetween 2001 and 2021, 2604 patients (median age 65; 67% male) underwent operative intervention for TAAD. Over this period, the number of aortic dissections recorded in the database annually increased (from <50 to >200 cases per year), consistent with the increasing number of contributing institutions. Thirty-day mortality rates varied by unit from 0% to 100%, with an average over the period of 18%. Despite unit case numbers ranging from 1 or 2 to over 200 cases, funnel plot analysis demonstrated no units fell outside the accepted 99.7% control level for 30-day mortality. Individual surgeons showed decreased mortality with increased caseload. Non-survivors were more likely to have prior respiratory or cerebrovascular disease, previous myocardial infarction, or severe left ventricular dysfunction. Post-operative stroke, return to theatre for bleeding, renal failure and atrial fibrillation were more common in the non-survivors (P < 0.05).

conclusionMortality outcomes for TAAD in Australia have improved over time, stabilizing at 18% over the last 5 years. Units performing fewer operations for TAAD showed equivalent mortality outcomes to high volume units, while surgeons performing fewer procedures displayed a higher mortality.

Indexed as

Aortic Aneurysm, ThoracicAortic DissectionAdultAgedAustraliaFemaleHumansMaleMiddle AgedNew ZealandPostoperative ComplicationsRetrospective StudiesTreatment Outcomecardiac surgerymortalitytype A aortic dissection

Identifiers

PMID39907174
PMCPMC12227844

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.