Abstract

 

OBJECTIVES

Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD.

METHODS

We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period).

RESULTS

The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00–1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01–1.23, P = 0.027). The peak incidence came 4–6 days after the moon was fully illuminated.

CONCLUSIONS

This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable.

中文翻译：

---

满月后：急性 A 型主动脉夹层和月相

摘要

 

目标

急性 A 型主动脉夹层 (ATAAD) 是一种罕见但严重的疾病，通常通过紧急心脏手术进行治疗。许多外科医生认为 ATAAD 患者往往成群出现，但没有研究检查过这些观察结果。这项调查旨在研究月球周期与 ATAAD 发病率之间的潜在关联。

方法

我们收集了在北欧急性 A 型主动脉夹层合作联盟中心接受 ATAAD 手术的 2995 名患者的信息。我们使用具有 2 种不同满月定义（>99% 照度和 7 天满月期）的病例交叉设计来交叉引用月相手术时间。

结果

月球被照亮最多的时期（99% 的定义）并未显示 ATAAD 手术的发病率有任何显着增加。然而，当将满月期与所有其他月相进行比较时，其产生的相对风险为 1.08 [95% 置信区间 (CI) 1.00-1.17，P  =  0.057]，并且与上弦月相比，只有相对风险为1.11（95% CI 1.01–1.23，P  = 0.027）。在月球被完全照亮后的 4-6 天，发病率达到峰值。

结论

这项研究发现在满月阶段 ATAAD 手术的比例过高。对此的解释尚不清楚，但我们推测满月期间的睡眠剥夺会导致血压暂时升高，进而可能引发主动脉壁破裂。虽然这一发现很有趣，但它需要得到证实，其临床意义是有争议的。