Outcomes before and after the Implementation of a Critical Pathway for Patients with Acute Aortic Disease
Yonsei Medical Journal
;
: 626-634, 2016.
Article
in English
| WPRIM
| ID: wpr-21853
ABSTRACT
PURPOSE:
Acute aortic diseases, such as aortic dissection and aortic aneurysm, can be life-threatening vascular conditions. In this study, we compared outcomes before and after the implementation of a critical pathway (CP) for patients with acute aortic disease at the emergency department (ED). MATERIALS ANDMETHODS:
This was a retrospective observational cohort study. The CP was composed of two phases PRE-AORTA for early diagnosis and AORTA for prompt treatment. We compared patients who were diagnosed with acute aortic disease between pre-period (January 2010 to December 2011) and post-period (July 2012 to June 2014).RESULTS:
Ninety-four and 104 patients were diagnosed with acute aortic disease in the pre- and post-periods, respectively. After the implementation of the CP, 38.7% of acute aortic disease cases were diagnosed via PRE-AORTA. The door-to-CT time was reduced more in PRE-AORTA-activated patients [71.0 (61.0, 115.0) min vs. 113.0 (56.0, 170.5) min; p=0.026]. During the post-period, more patients received emergency intervention than during the pre-period (22.3% vs. 36.5%; p=0.029). Time until emergency intervention was reduced in patients, who visited the ED directly, from 378.0 (302.0, 489.0) min in the pre-period to 200.0 (170.0, 299.0) min in the post-period (p=0.001). The number of patients who died in the ED declined from 11 to 4 from the pre-period to the post-period. Hospital mortality decreased from 26.6% to 14.4% in the post-period (p=0.033).CONCLUSION:
After the implementation of a CP for patients with acute aortic disease, more patients received emergency intervention within a shorter time, resulting in improved hospital mortality.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Aorta
/
Aortic Aneurysm
/
Outcome and Process Assessment, Health Care
/
Aortic Diseases
/
Postoperative Complications
/
Time Factors
/
Vascular Surgical Procedures
/
Acute Disease
/
Retrospective Studies
/
Treatment Outcome
Type of study:
Practice guideline
/
Observational study
/
Prognostic study
/
Screening study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
Yonsei Medical Journal
Year:
2016
Type:
Article
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