Disease Progression, Treatment and Follow-up
During the acute phase, the occurrence rate of disease progression (20 of 89 patients) was higher in the non-DM group than in the DM group (4 of 60 patients) (22% vs 7%, P =0.011), and disease progression occurred significantly earlier in the non-DM group than in the DM group (6.4±1.3 vs 12.0±1.4 days, P <0.001). The incidence of disease progression was greater in non-DM patients than in DM patients, and the types of disease progression are listed in Table 2. Compared to those in the DM group, more patients in the non-DM group received TEVAR treatment during the acute phase (12% vs 2%, P =0.028). The two deaths after TEVAR treatment in the non-DM group included one patient who died of retrograde type A aortic dissection and one patient who died of aortic rupture (Figure 2 and Figure 3 ).
The aorta-related mortality in patients with IMHBs is also summarized inTable 2 and Figure 4. There were significant differences in aorta-related death among the DM and non-DM groups during the acute phase (<14 days) (0% vs 9%, P =0.042) (Table 2 ). The non-DM group also had a higher reintervention rate during follow-up than the DM group (9 in 81 patients, 11% vs 2%,P =0.043). Additionally, the non-DM group had a higher probability of hematoma worsening (22% vs 5%, P =0.004) and a higher rate of aorta-related mortality during the follow-up period (11% vs 2%,P =0.043) than the DM group (Table 2 ).
The Cox regression analysis revealed that ULP development (during the acute phase) (HR, 1.07; 95% CI, 1.01-1.31, P=0.008), CRP level (HR, 1.92; 95% CI, 1.51-2.49, P<0.001) and MMP-9 level (HR, 16.82; 95% CI, 7.52-28.71, P<0.001) were associated with an elevated risk for aorta-related mortality (Table 3 ). The Kaplan-Meier survival analysis revealed a significant increase in the aortic-related mortality rate in the DM group compared with that in the non-DM group (P =0.0023, Figure 4 ).