Impact of time between diagnosis to treatment in Acute Type A Aortic Dissection

Abstract There is a paucity of data describing the effect of time interval between diagnosis and surgery for Acute Type A Aortic Dissection. We describe our 8-year experience and investigate the impact of time interval between symptom onset, diagnosis and surgery on outcomes. Retrospective single-ce...

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Autores principales:	Caleb R. Matthews, Mackenzie Madison, Lava R. Timsina, Niharika Namburi, Zainab Faiza, Lawrence S. Lee
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/69e99ff422b64e1b8a44e9facd02b256
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spelling	oai:doaj.org-article:69e99ff422b64e1b8a44e9facd02b2562021-12-02T14:11:31ZImpact of time between diagnosis to treatment in Acute Type A Aortic Dissection10.1038/s41598-021-83180-62045-2322https://doaj.org/article/69e99ff422b64e1b8a44e9facd02b2562021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-83180-6https://doaj.org/toc/2045-2322Abstract There is a paucity of data describing the effect of time interval between diagnosis and surgery for Acute Type A Aortic Dissection. We describe our 8-year experience and investigate the impact of time interval between symptom onset, diagnosis and surgery on outcomes. Retrospective single-center study utilizing our Society of Thoracic Surgeons registry and patient records. Subjects were grouped by time interval between radiographic diagnosis and surgical treatment: Group A (0–4 h), Group B (4.1–8 h), Group C (8.1–12 h), and Group D (12.1 + h). Data were analyzed to identify factors associated with mortality and outcomes. 164 patients were included. Overall mortality was 21.3%. Group C had the greatest intervals between symptom onset to diagnosis to surgery, and also the highest mortality (66.7%). Preoperative tamponade, cardiac arrest, malperfusion, elevated creatinine, cardiopulmonary bypass time, and blood transfusions were associated with increased mortality, while distance of referring hospital was not. Time intervals between symptom onset, diagnosis and surgery have a significant effect on mortality. Surgery performed 8–12 h after diagnosis carries the highest mortality, which may be exacerbated by longer interval since symptom onset. Time-dependent effects should be considered when determining optimal strategy especially if inter-facility transfer is necessary.Caleb R. MatthewsMackenzie MadisonLava R. TimsinaNiharika NamburiZainab FaizaLawrence S. LeeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Caleb R. Matthews Mackenzie Madison Lava R. Timsina Niharika Namburi Zainab Faiza Lawrence S. Lee Impact of time between diagnosis to treatment in Acute Type A Aortic Dissection
description	Abstract There is a paucity of data describing the effect of time interval between diagnosis and surgery for Acute Type A Aortic Dissection. We describe our 8-year experience and investigate the impact of time interval between symptom onset, diagnosis and surgery on outcomes. Retrospective single-center study utilizing our Society of Thoracic Surgeons registry and patient records. Subjects were grouped by time interval between radiographic diagnosis and surgical treatment: Group A (0–4 h), Group B (4.1–8 h), Group C (8.1–12 h), and Group D (12.1 + h). Data were analyzed to identify factors associated with mortality and outcomes. 164 patients were included. Overall mortality was 21.3%. Group C had the greatest intervals between symptom onset to diagnosis to surgery, and also the highest mortality (66.7%). Preoperative tamponade, cardiac arrest, malperfusion, elevated creatinine, cardiopulmonary bypass time, and blood transfusions were associated with increased mortality, while distance of referring hospital was not. Time intervals between symptom onset, diagnosis and surgery have a significant effect on mortality. Surgery performed 8–12 h after diagnosis carries the highest mortality, which may be exacerbated by longer interval since symptom onset. Time-dependent effects should be considered when determining optimal strategy especially if inter-facility transfer is necessary.
format	article
author	Caleb R. Matthews Mackenzie Madison Lava R. Timsina Niharika Namburi Zainab Faiza Lawrence S. Lee
author_facet	Caleb R. Matthews Mackenzie Madison Lava R. Timsina Niharika Namburi Zainab Faiza Lawrence S. Lee
author_sort	Caleb R. Matthews
title	Impact of time between diagnosis to treatment in Acute Type A Aortic Dissection
title_short	Impact of time between diagnosis to treatment in Acute Type A Aortic Dissection
title_full	Impact of time between diagnosis to treatment in Acute Type A Aortic Dissection
title_fullStr	Impact of time between diagnosis to treatment in Acute Type A Aortic Dissection
title_full_unstemmed	Impact of time between diagnosis to treatment in Acute Type A Aortic Dissection
title_sort	impact of time between diagnosis to treatment in acute type a aortic dissection
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/69e99ff422b64e1b8a44e9facd02b256
work_keys_str_mv	AT calebrmatthews impactoftimebetweendiagnosistotreatmentinacutetypeaaorticdissection AT mackenziemadison impactoftimebetweendiagnosistotreatmentinacutetypeaaorticdissection AT lavartimsina impactoftimebetweendiagnosistotreatmentinacutetypeaaorticdissection AT niharikanamburi impactoftimebetweendiagnosistotreatmentinacutetypeaaorticdissection AT zainabfaiza impactoftimebetweendiagnosistotreatmentinacutetypeaaorticdissection AT lawrenceslee impactoftimebetweendiagnosistotreatmentinacutetypeaaorticdissection
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Impact of time between diagnosis to treatment in Acute Type A Aortic Dissection

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