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Hospital volumes an...
Hospital volumes and later year of operation correlates with better outcomes in acute Type A aortic dissection
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- Geirsson, Arnar (author)
- Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
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- Ahlsson, Anders, 1962- (author)
- Karolinska Institutet
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- Franco-Cereceda, Anders (author)
- Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden
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- Fuglsang, Simon (author)
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Denmark
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- Gunn, Jarmo (author)
- Department of Surgery, Heart Center, Turku University Hospital, University of Turku, Turku, Finland
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- Hansson, Emma C., 1985 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Hjortdal, Vibeke (author)
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Denmark
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- Jarvela, Kati (author)
- Department of Cardiothoracic Surgery, Heart Center Tampere University Hospital, Tampere, Finland
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- Jeppsson, Anders, 1960 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Mennander, Ari (author)
- Department of Cardiothoracic Surgery, Heart Center Tampere University Hospital, Tampere, Finland
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- Nozohoor, Shahab (author)
- Department of Cardiothoracic Surgery, Skåne University Hospital, Lund, Sweden
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- Olsson, Christian (author)
- Karolinska Institutet
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- Pan, Emily (author)
- Department of Surgery, Heart Center, Turku University Hospital, University of Turku, Turku, Finland
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- Wickbom, Anders, 1987- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden
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- Zindovic, Igor (author)
- Department of Cardiothoracic Surgery, Skåne University Hospital, Lund, Sweden
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- Gudbjartsson, Tomas (author)
- Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
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(creator_code:org_t)
- 2017-07-25
- 2018
- English.
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In: European Journal of Cardio-Thoracic Surgery. - : Oxford University Press. - 1010-7940 .- 1873-734X. ; 53:1, s. 276-281
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Abstract
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- OBJECTIVES: Acute Type A aortic dissection remains a life-threatening disease, but there are indications that its surgical mortality is decreasing. The aim of this report was to study how surgical mortality has changed and what influences those changes.METHODS: Nordic Consortium for Acute Type A Aortic Dissection is a retrospective database comprising 1159 patients (mean age 61.6 ± 12.2 years, 68% male) treated for acute Type A aortic dissection at 8 centres in Denmark, Finland, Iceland and Sweden from 2005 to 2014. Data gathered included demographics, symptoms, type of procedure, complications and 30-day mortality.RESULTS: The annual number of operations increased significantly from 85 in 2005 to 150 in 2014 (P < 0.001). Chest pain was present in 85% of patients, 24% were hypotensive on presentation and 28% had malperfusion syndrome. Open distal anastomosis technique under hypothermic circulatory arrest was used in 85% of cases and its use increased significantly throughout the study. The 30-day mortality decreased from 24% in 2005 to 13% in 2014 (P = 0.003). Independent predictors for 30-day mortality were preoperative cardiac arrest, malperfusion syndrome, Penn Class C, Penn Class B and C and cardiopulmonary bypass time, whereas later calendar year and higher hospital operative volumes predicted improved survival.CONCLUSIONS: Surgical mortality for acute Type A aortic dissection remains high but has decreased significantly over the last decade. This correlated with later year of operation and increased the number of operations performed per year, indicating that cumulative surgical experience contributes significantly to improved surgical outcomes.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Keyword
- Aortic dissection
- aortic operation
- complications
- outcomes
- surgery
Publication and Content Type
- ref (subject category)
- art (subject category)
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Geirsson, Arnar
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Ahlsson, Anders, ...
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Franco-Cereceda, ...
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Fuglsang, Simon
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Gunn, Jarmo
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Hansson, Emma C. ...
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Hjortdal, Vibeke
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Jarvela, Kati
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Jeppsson, Anders ...
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Mennander, Ari
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Nozohoor, Shahab
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Olsson, Christia ...
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Pan, Emily
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Wickbom, Anders, ...
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Zindovic, Igor
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Gudbjartsson, To ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Surgery
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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- Articles in the publication
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European Journal ...
- By the university
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Örebro University
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Karolinska Institutet
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University of Gothenburg