The effect of referral and transfer of patients with acute type A aortic dissection on treatment outcomes

Özet

Objectives: This study aims to evaluate the effect of referral and transfer of patients with acute type A aortic dissection (AAAD) andtreatment outcomes in the emergency setting.Patients and methods: A total of 131 patients (75 males, 56 females; mean age 52.2±13.1 years; range, 18 to 80 years) who underwent surgerydue to AAAD in the emergency setting in our center between January 2010 and December 2017 were included in the study. The patientswere divided into two groups as those who were diagnosed with AAAD in another health care facility and transferred to our hospital (GroupA, n=65) and those who were diagnosed in our emergency room (Group B, n=66).Results: The rate of postoperative neurological complications was 24.6% in Group A and 12.1% in Group B (p=0.74). The postoperativepersistent neurological deficit rate was 10.5% in Group A and 9% in Group B (p=0.456). The overall hospital mortality rate was 23.2%(p=0.310). Hemodynamic instability, age, and cardiopulmonary bypass time were independent risk factors for overall hospital mortality.Conclusion: Although the patients diagnosed with AAAD in another healthcare facility were hemodynamically unstable compared to thosediagnosed in our center, the mortality and morbidity rates did not significantly differ. Based on our study results, we recommend transferringsuch patients to a reference hospital.