Questions and Objectives:
This study aims to bridge a critical gap in understanding aortic dissection (AD) outcomes by integrating large-scale population-based data with detailed hospital-based clinical data. The primary research question is: What are the key determinants of short- and long-term mortality in aortic dissection patients, and how do risk profiles and outcomes compare between a Western general population (UK) and a Chinese clinical cohort? Our specific objectives are: 1. To quantify and compare mortality rates; 2. To identify universal and cohort-specific risk factors; 3. To develop and validate a clinical prediction model; 4. To analyze temporal and demographic disparities.
Scientific Rationale:
Aortic dissection is a catastrophic cardiovascular emergency with mortality rates exceeding 1% per hour in the acute phase without treatment. While population studies from databases like the UK Biobank have established strong, dose-response links between hypertension and the incidence of AD, there is a stark disconnect between these population-level risk factors and the clinical predictors of death after diagnosis. Large clinical registries like IRAD have advanced our knowledge, but data from Chinese populations, where AD may have distinct etiological and prognostic profiles, remain less represented in the international literature.
Recent analyses of U.S. mortality data reveal complex trends: an overall decline over decades but a concerning recent upturn and persistent disparities, with higher mortality among men and Black individuals. The proposed study directly addresses these gaps by performing a parallel analysis of two complementary datasets. This trans-cohort design enables a unique investigation into whether the risk factors for getting AD are the same as those for dying from it, across different ethnic and healthcare settings.
