Development of a core outcome set for type B aortic dissection

Project Overview

Type B aortic dissection (TBAD) is a disease that can kill people of any age and has a 30-day mortality rate of 13.3% during the acute phase. TBAD has a bimodal age distribution, which means that it is most common in younger people with connective tissue aortopathy and in older people with high blood pressure.

By 2050, the number of TBAD cases in the UK is expected to double, from 3,892 in 2010 to 6,893.

90% of TBAD patients are discharged from hospital alive thanks to medical care, which involves strict blood pressure control and following surveillance imaging. However, current aortic remodelling to prevent dilatation or dissection in the longer term is only sufficient to support 25% of these patients, with a resulting 3-year survival of only 76% due to late rupture. As a result, this inadequate modelling is a significant late source of morbidity, mortality, and resource use.

Because of the potentially fatal consequences such as stroke, paraplegia, and potential type A dissection, consensus and evidence in favour of surgical therapies to induce aortic remodelling in subacute/chronic TBAD remain unclear.

The choice of outcomes that are assessed and reported, as well as the decisions on the course of therapy, should therefore engage patients as important stakeholders. The impacts of therapies will be captured in a form that is pertinent and meaningful to patients if they are involved in outcome measures.