Date of Award

January 2016

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Trace S. Kershaw

Second Advisor

John A. Elefteriades

Abstract

Background: Studies have shown a significant association between family history and aortic aneurysm but this relationship has yet to be explored in depth with dissections. This study examined the role of three family histories (dissection, aortic aneurysm, and sudden death) with the objective to find the best indicator of dissection development.

Methods: A total of N=278 patients seen at Yale between 2013-2015 for aortic aneurysm and dissections were enrolled and their family histories obtained. Six indicators were examined 1) family history of dissection 2) family history of aortic aneurysm 3) family history of sudden death 4) family history of dissection or aortic aneurysm 5) family history of dissection or sudden death and 6) family history of dissection or aortic aneurysm or sudden death.

Results: Patients with a family history of dissection or sudden death were 1.73 (p = 0.038; 95% CI 1.03, 2.90) times as likely to have a dissection compared to those with a negative family history. Patients with a positive family history of aortic aneurysm were 2.31 (p = 0.027; 95% CI 1.10, 4.85) times as likely to have a dissection compared to those with a negative family history (adjusted). Patients with a positive family history of dissection or aortic aneurysm or sudden death were 1.80 (p=0.0487; 95% CI 1.00, 3.23) times as likely to have a dissection compared to those with a negative family history (adjusted).

Conclusion: Three indicators were significant in predicting dissection outcomes 1) family history of dissection or sudden death 2) family history of aortic aneurysm and 3) family history of dissection or aortic aneurysm or sudden death. These findings suggest increased screening for patients with positive corresponding family histories.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 06/07/2018

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