Abstract：
Acute type A aortic dissection (ATAAD) is a life-threatening emergency that is associated with a high morbidity and mortality rate. One of the complications is end-organ ischemia, a known predictor of mortality. The primary aims of this meta-analysis were to summarize the findings of observational studies investigating the utility of the Penn classification system and to analyze the incidence rates and mortality patterns within each class. The electronic databases PubMed, MEDLINE, and Embase were searched through to April 2023. These were filtered by multiple reviewers to give 10 studies that met the inclusion criteria. The extracted data included patient characteristics, and primary outcomes were the incidence rates of different Penn classes, along with the corresponding mortality for each class. Out of 1,512 studies identified during the initial search, 10 studies, including 4,494 patients, met the inclusion criteria. The pooled incidence of Penn A was highest at 0.55 (95% CI 0.52, 0.58), followed by Penn B at 0.21 (95% CI 0.17, 0.25), and finally Penn C at 0.14 (95% CI 0.11, 0.17). Patients with Penn BC were found to be at the highest risk of death, as their early mortality rates were 0.36 (95% CI 0.31, 0.41). Within those populations, the subtype with the highest individual mortality was Penn C at 0.21 (95% CI 0.15, 0.27), followed by Penn B at 0.19 (95% CI 0.15, 0.23) and Penn A at 0.07 (95% CI 0.05, 0.10). Among patients presenting with ATAAD, class A was most frequently observed, followed by classes B, C, and BC. These findings indicate an incremental increase in mortality rates with the progression of Penn classification.
摘要：
急性A型主动脉夹层（ATAAD）是一种危及生命的紧急情况，与高发病率和死亡率有关。并发症之一是终末器官缺血，已知的死亡率预测因子。这项荟萃分析的主要目的是总结观察性研究的结果，调查宾夕法尼亚大学分类系统的实用性，并分析每个类别内的发病率和死亡率模式。电子数据库PubMed，MEDLINE,和Embase被搜索到2023年4月。这些由多个审阅者过滤，得到10项符合纳入标准的研究。提取的数据包括患者特征，主要结果是不同宾夕法尼亚大学班级的发病率，以及每个班级的相应死亡率。在最初搜索期间确定的1,512项研究中，10研究,包括4494名患者，符合纳入标准。PennA的合并发生率最高，为0.55（95％CI0.52，0.58），其次是宾夕法尼亚大学B，为0.21（95%CI0.17，0.25），最后是宾夕法尼亚大学的0.14（95%CI0.11，0.17）。PennBC患者的死亡风险最高，早期死亡率为0.36(95%CI0.31,0.41).在这些人群中,个体死亡率最高的亚型是PennC，为0.21(95%CI0.15，0.27)，其次是PennB，0.19（95%CI0.15，0.23）和PennA，0.07（95%CI0.05，0.10）。在患有ATAAD的患者中，A类是最常见的，其次是B类，C,BC。这些发现表明，随着Penn分类的进展，死亡率逐渐增加。
