Acute Type-A Aortic Dissection in Hunter New England—A 10-Year Regional Australian Experience

Background

Acute aortic dissection (AD) is a surgical emergency with significant mortality without prompt diagnosis and operative intervention. The management is time critical, and regional Australia represents an area of interest owing to its large distances and often paucity of resources. No previous studies examining Type-A AD in regional Australia have been done. The aim of this study is to describe acute Type-A AD within a regional population of Australia. The primary outcomes were incidence and mortality. The secondary outcomes were assessment of risk factors, challenges in diagnosis, and associated complications.

Methods

A retrospective analysis was undertaken in the Hunter New England (HNE) health district of New South Wales (NSW) from 2010 to 2020. A total of 122 patients with an ICD-10 diagnosis of Type-A AD were included in the study. The data was analysed using the statistical package for the social sciences (SPSS). Odds ratio and 95% confidence interval (CI) were reported, and statistical significance was assumed at p < 0.05.

Results

The incidence of Type-A AD in the HNE was 1.27 per 100 000 and overall mortality was 14.5%. Five percent of patients identified as Aboriginal and Torres Strait Islander. Combined risk factors of smoking and hypertension, postoperative CVA, and misdiagnosis demonstrated higher mortality which was statistically significant (p < 0.05).

Conclusion

This study is the first study to illustrate Type-A AD in regional Australia. The findings reported here present a solid foundation for future studies to better understand the challenges faced in the diagnosis and management of AD.