Editor-in-Chief Ufuk Demirkılıç Frequency Quarterly Abbreviation Turk J Vasc Surg Publisher Turkish National Vascular and Endovascular Surgery Society ISSN 2667-4947 E-ISSN 2667-5080

Turkish Journal of Vascular Surgery 2020 , Vol 29 , Issue 1
The effect of referral and transfer of patients with acute type A aortic dissection on treatment outcomes
Ersin Kadiroğulları1, Onur Şen1, Safa Göde1, Muhammed Bayram1, Abdülkerim Buğra1, Barış Timur1, Erhan Kutluk1, Ünal Aydın1, Burak Onan1
1Department of Cardiovascular Surgery, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey DOI : 10.9739/tjvs.2020.454 Objectives: This study aims to evaluate the effect of referral and transfer of patients with acute type A aortic dissection (AAAD) and treatment 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 surgery due to AAAD in the emergency setting in our center between January 2010 and December 2017 were included in the study. The patients were divided into two groups as those who were diagnosed with AAAD in another health care facility and transferred to our hospital (Group A, 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 postoperative persistent 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 those diagnosed in our center, the mortality and morbidity rates did not significantly differ. Based on our study results, we recommend transferring such patients to a reference hospital. Keywords : Mortality, referral, transfer, type A aortic dissection