Evidence mapPaperPMID 42583322Full record

ArticleJournal of thoracic disease2026

Sex differences in pain presentation and its association with distal extent in acute type A aortic dissection: a retrospective cohort study.

Ruben Methorst, Ferdinand K P Bruning, Monique R M Jongbloed, Jesper Hjortnaes, Marco C DeRuiter

Abstract read
In one paragraph

Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ruben MethorstDepartment of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands.
Ferdinand K P BruningDepartment of Cardiothoracic Surgery, Heart & Lung Center, Leiden University Medical Center, Leiden, The Netherlands.
Monique R M JongbloedDepartment of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands.
Jesper HjortnaesDepartment of Cardiothoracic Surgery, Heart & Lung Center, Leiden University Medical Center, Leiden, The Netherlands.
Marco C DeRuiterDepartment of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Acute type A aortic dissection (ATAAD) is a life-threatening acute disease that requires swift diagnosis and surgical intervention. ATAAD patients typically present with acute stabbing chest pain and/or a tearing sensation between the shoulder blades. However, women have been reported to present more frequently with atypical symptoms, which is hypothesized to contribute to delayed diagnosis time and increased short-term mortality. This indicates that a more thorough insight into sex-differences in pain manifestation of ATAAD is required to improve diagnostic accuracy and shorten time to intervention reducing mortality, especially in women. This study investigated sex differences in pain manifestation in patients with ATAAD and their association with distal extent of dissection. Methods: We studied pain manifestation in a single-center cohort study of 460 ATAAD patients who underwent surgical treatment between 1992 and 2025 in the Leiden University Medical Center. Patients with incomplete symptom documentation (N=82) and diabetes mellitus (DM) (N=9) were excluded. Results: We found that chest pain is a strong indicator for ATAAD in both sexes. Women, however, present more often with non-specific back pain (P=0.053), dyspnea (P=0.003), and collapse (P=0.04). Men were found to have a further distal extent of dissection compared to women (P<0.001). Men more often presented with one prominent symptom, whereas women experienced a more diverse set of symptoms (P=0.006). Of note, patients with an ascending-contained dissection presented more frequently without any symptoms (P=0.005). Distal extent of dissection showed a significant association with increased likelihood of paraplegia (P<0.001) and abdominal pain (P=0.004), especially in men. Conclusions: Although chest pain remains a significant diagnostic hallmark of ATAAD, we showed significant sex-differences in pain manifestation of ATAAD. This study contributes to mounting evidence that there is sex-related difference in symptomatology in patients presented with ATAAD.

Indexed as

Acute type A aortic dissection (ATAAD)pain manifestationsex differences

Identifiers

PMID42583322
PMCPMC13460135

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.