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19.11.2018 | original article | Ausgabe 7-8/2019 Open Access

Wiener klinische Wochenschrift 7-8/2019

Factors limiting physical activity after acute type A aortic dissection

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 7-8/2019
Autoren:
MD Associate Professor Thomas Schachner, Fabian Garrido, Nikolaos Bonaros, Christoph Krapf, Julia Dumfarth, Michael Grimm

Summary

Background

Acute type A aortic dissection (AAD) leads to high hospital mortality rates in the first 48 h after the onset of symptoms. Survivors, however, have good long-term perspectives and enhanced survival especially if regaining moderate amounts of physical activity.

Methods

This study analyzed 131 survivors (from 180 consecutive patients, aged 60 years (rande 30–84 years, 71% male) of acute AAD after a median time of 44 months (range 1–147 months). The hospital mortality was 13.5%. The group of physically active patients was compared with those with a sedentary life style. The qualitative and quantitative data on physical activity were correlated with data from an aortic registry.

Results

Overall 87% of patients reported 1 or more types of physical activities after hospital discharge. The most common types were walking (51%), biking (29%), hiking (15%) and gymnastics (14%). Patients with a sedentary life style underwent longer hypothermic circulatory arrest times (39 min, range 8–167 min vs. 47 min, range 27–79 min, p = 0.009), had a longer intensive care unit (ICU) stay (Pearsons r = −0.226 [between length of ICU stay and hours of physical activity after hospital discharge], p = 0.033) and suffered more frequently from postoperative paresis (33.3% vs. 3.8%, p < 0.001) compared with physically active patients. Binary logistic regression analysis showed female gender (p = 0.026) and higher body mass index (p = 0.019) to be independently associated with a reduced amount of physical activity.

Conclusions

This study demonstrate that the majority of survivors of acute aortic dissection type A regain a physically active life including the practice of a variety of sports. Factors predictive of a sedentary life style can be identified. Female patients deserve special attention.
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