Influence of diabetes on short-term mortality of patients with acute type A aortic dissection: a meta-analysis
Bibliographic record
Abstract
Acute type A aortic dissection (ATAAD) is a life-threatening cardiovascular emergency with substantial early mortality. Whether diabetes mellitus (DM) independently influences short-term mortality in ATAAD remains uncertain. We conducted a meta-analysis to synthesize the available data. PubMed, Embase, and Web of Science were searched from inception to June 22, 2025, for longitudinal studies reporting short-term mortality (in-hospital or 30-day) in ATAAD patients with and without DM. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model accounting for the influence of heterogeneity. Subgroup, sensitivity, and meta-regression analyses explored heterogeneity. The study quality was assessed with the Newcastle–Ottawa Scale (NOS). Twenty-one retrospective cohort studies involving 19,291 patients were included. DM was associated with a modestly increased short-term mortality risk (OR = 1.48; 95% CI 1.14 to 1.91; p = 0.003; I 2 = 44%). The results were consistent in sensitivity analyses restricted to surgical patients (OR = 1.52; 95% CI 1.18 to 1.96; p = 0.001). Subgroup analyses showed no significant differences by region, follow-up duration, analytic model, or NOS score (all p for subgroup differences > 0.05). Meta-regression analysis showed that sample size was negatively correlated with the association (coefficient = − 0.000074, p = 0.02), which fully explained the source of heterogeneity (adjusted R 2 = 100%). This meta-analysis of retrospective studies suggests that DM may be associated with higher short-term mortality in ATAAD. Given the observational nature of the evidence, further prospective studies are needed to clarify this relationship.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".