Time critical diagnoses and transfers of patients with acute type A aortic dissection in the UK : national audit of current practice*
Authors' conclusion
Our findings show the acuity, clinical severity and vulnerability of patients with type A aortic dissection, and the deficits in the process of diagnosis and the quality of transfer.
Study context
- Population
- Patients with acute type A aortic dissection, 28 UK cardiac centres over 12 months
- Participants
- 334 patients · 28 UK cardiac centres
- Outcome
- Time from symptom onset to ED arrival and from ED arrival to start of surgery; diagnostic and transfer delays
Methodological detailsmulticentre, Undertaken by the Association for Cardiothoracic Anaesthesia and Critical Care
- Multicentre
- Undertaken by the Association for Cardiothoracic Anaesthesia and Critical Care
Main finding
As reported in the abstract
- Median (IQR [range]) time from symptom onset to ED arrival, h
- 2.3 (1.4-4.7 [0.1-491.6])
- Median (IQR [range]) time from ED arrival to start of surgery, h
- 9.5 (6.1-18.2 [0.8-363.5])
- Delays in diagnosis and transfers
- 158 (47.3%)
- Initial misdiagnosis
- 52 (15.6%)
- Medical doctor accompanied patient during transfer
- 50 (15.0%)
Observational data: associations, not effects.
Further findings
In-hospital mortality
- Died in hospital
- 64 (19.2%)
- Died within first 5 days after surgery
- 41 (12.3%)
Safety
Clinical deterioration before arrival in operating theatre
- Deteriorated clinically before arrival in operating theatre
- 56 (16.8%)
Original publication
Time critical diagnoses and transfers of patients with acute type A aortic dissection in the UK : national audit of current practice*. Anaesthesia. Published 7 October 2024. doi:10.
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