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10.3349/ymj.2016.57.3.626

http://scihub22266oqcxt.onion/10.3349/ymj.2016.57.3.626
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suck abstract from ncbi


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pmid26996561
      Yonsei+Med+J 2016 ; 57 (3 ): 626-34
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  • Outcomes before and after the Implementation of a Critical Pathway for Patients with Acute Aortic Disease #MMPMID26996561
  • Shin KC ; Lee HS ; Park JM ; Joo HC ; Ko YG ; Park I ; Kim MJ
  • Yonsei Med J 2016[May]; 57 (3 ): 626-34 PMID26996561 show ga
  • 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 AND METHODS: 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.
  • |*Critical Pathways [MESH]
  • |Acute Disease [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Aorta [MESH]
  • |Aortic Aneurysm/diagnosis/mortality/*surgery [MESH]
  • |Aortic Diseases/diagnosis/mortality/*surgery [MESH]
  • |Aortic Dissection/diagnosis/mortality/*surgery [MESH]
  • |Emergency Service, Hospital/*organization & administration [MESH]
  • |Female [MESH]
  • |Hospital Mortality [MESH]
  • |Humans [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Outcome and Process Assessment, Health Care [MESH]
  • |Postoperative Complications/mortality [MESH]
  • |Republic of Korea/epidemiology [MESH]
  • |Retrospective Studies [MESH]
  • |Time Factors [MESH]
  • |Treatment Outcome [MESH]


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