Analysis of epidemiological characteristics and prognosis based on 1,343 cases of aortic dissection from a regional single center

Objective To analyze the clinical epidemiological characteristics, treatment trends, and risk factors for in-hospital mortality in patients with aortic dissection (AD) at a single center, so as to provide references for early diagnosis and intervention in the emergency department. Methods A retrospective analysis was conducted on the medical records of 1343 AD patients admitted between 2011 and 2024. Statistical descriptions were performed for baseline characteristics, clinical manifestations, imaging classification, treatment, and outcomes. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors for in-hospital mortality. Results Among the 1,343 patients, 82.7% were male, with a mean age of 52.7 ± 12.4 years; 71.3% had hypertension. Stanford type A and type B AD accounted for 41.7% and 58.3%, respectively. Acute onset was observed in 76.5% of patients, with chest pain (66.4%) being the most common symptom. The onset of AD showed seasonal (peak in winter, especially December) and diurnal (76.6% of cases presented between 12:00 and 23:00) clustering trends. The rate of surgery was 62.0%, showing an increasing trend over the years. The overall mortality rate was 10.0% (95% CI: 8.4%–11.8%), with type A mortality (16.9%, 95% CI: 14.2%–19.9%) significantly higher than that of type B (4.0%, 95% CI: 2.7%–5.7%). Multivariate analysis identified acute onset (OR = 3 .484),chest pain (OR = 1 .658), increased heart rate (OR = 1 .017), Stanford type A (OR = 3 .959) and larger false lumen diameter (OR = 1 .357) as independent risk factors for in-hospital mortality (all P < 0.05). Surgery treatment (OR = 0 .194) was a protective factor against in-hospital mortality, Conclusion This study indicates that AD predominantly affects middle-aged and elderly males with hypertension, with distinct temporal and seasonal patterns. Acute onset, chest pain, type A dissection, higher heart rate, non-surgical, and larger false lumen diameter significantly increase the risk of in-hospital mortality, highlighting the need for increased vigilance in emergency clinical practice.