Time is of the essence: where can we improve care in acute aortic dissection?
| Autor: | Joscha Buech, Nikolaos Tsilimparis, T. Fabry, D Joskowiak, Shekhar Saha, Maximilian Pichlmaier, Ahmad Ali, Sven Peterss, Christian Hagl |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Pediatrics medicine.medical_specialty Referral Thoracic 030204 cardiovascular system & hematology Tertiary care Tertiary Care Centers 03 medical and health sciences Patient referral 0302 clinical medicine medicine.artery medicine Humans Aged Retrospective Studies Aortic dissection Aorta Aortic Aneurysm Thoracic business.industry medicine.disease Optimal management Aortic Dissection 030228 respiratory system Quartile Acute Disease Hospital admission Surgery Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Interact Cardiovasc Thorac Surg |
| ISSN: | 1569-9285 |
| DOI: | 10.1093/icvts/ivab190 |
| Popis: | OBJECTIVES In acute aortic dissection type A various components of the diagnostic and logistic pathways may affect the time to definitive treatment. This study aimed to characterize these components and to identify factors delaying the optimal management within our institutional referral network. METHODS Between January 2017 and January 2020, 96 consecutive patients with classical aortic dissection type A were admitted (28%) or referred (72%) to our tertiary care centre and analysed retrospectively. Data are presented as medians (25th–75th quartile). RESULTS Median age was 66 years (56–74), 63% were male. Most of the patients were primarily admitted to a cardiology department (40%), whereas about a fourth were admitted to departments for internal medicine (26%) and general surgery (27%). The median interval from the onset of symptoms to hospital admission was 2.1 (1–4.4) h. From admission to confirmed diagnosis it took 2.1 (0.6–9.5) h and the median interval from confirmed diagnosis to admission at our specialized tertiary care aortic centre was 1.5 (0.9–2.4) h. Following admission to our centre, 1.1 (0.5–1.9) h passed until the induction of anaesthesia and 0.8 (0.0–1.1) h until the start of surgery. The total interval from the onset of symptoms to the start of surgery was 7.6 h (5.1–12.3). CONCLUSIONS The marked variability of the time from symptoms to diagnosis at any medical facility demonstrates the importance of awareness in the optimization of the treatment of acute aortic dissection type A. |
| Databáze: | OpenAIRE |
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