This retrospective cohort study aimed to evaluate the association between symptom-to-admission time and postoperative outcomes following Type A acute aortic dissection (TAAD) repair. Analyzing 1,228 patients treated within 72 hours of symptom onset, the cohort was stratified into early (≤12 hours) and late (>12–72 hours) admission groups. Results demonstrated that early-presenting patients exhibited significantly higher baseline acuity, including elevated rates of preoperative limb ischemia, hypotension, and bradycardia. Consequently, the early group experienced worse postoperative outcomes, with significantly higher in-hospital mortality (15 percent vs 9.4 percent), stroke (5.8 percent vs 2.8 percent), and acute kidney injury. The authors thus concluded that preoperative clinical status, particularly malperfusion, primarily dictates surgical prognosis, hence underscoring the need for individualized risk stratification over strictly time-driven decision-making in TAAD.
