Postmortem computed tomography (PMCT) has been recently reported to be useful for
detecting causes of death in the emergency department. In this study, the incidence
and causes of death of type A acute aortic dissection (AAD) were investigated in patients
who experienced out-of-hospital cardiopulmonary arrest (OHCPA) using PMCT. PMCT or
enhanced computed tomography was performed in 311 of 528 consecutive patients experiencing
OHCPA. A total of 23 (7%) of 311 patients were diagnosed with type A AAD based on
clinical courses and CT findings. Eighteen consecutive patients who did not experience
OHCPA were diagnosed with type A AAD during the same period. Pre-hospital death was
observed in 21 (51%) of 41 patients with type A AAD. Bloody pericardial effusion was
observed more frequently in patients who experienced OHCPA with type A AAD than in
those who did not experience OHCPA with type A AAD (91% vs 28%, respectively; p <0.05).
In conclusion, the incidence of type A AAD was common (7%) in patients who experienced
OHCPA, with a high rate of pre-hospital death. Aortic rupture to the intrapericardial
space was considered the major cause of death in patients who experienced OHCPA with
type A AAD.
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Article info
Publication history
Published online: March 19, 2016
Accepted:
March 10,
2016
Received in revised form:
March 10,
2016
Received:
November 29,
2015
Footnotes
This work was performed at the Teine Keijinkai Hospital, Sapporo, Japan.
See page 1830 for disclosure information.
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Copyright
© 2016 Elsevier Inc. All rights reserved.
