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Diagnostic and refe...
Diagnostic and referral delay in patients with aortic stenosis is common and negatively affects outcome
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- Gjertsson, Peter, 1961 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,University of Gothenburg
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- Caidahl, Kenneth, 1949 (författare)
- Karolinska Institutet,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,University of Gothenburg
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- Odén, Anders, 1942 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för matematiska vetenskaper,Department of Mathematical Sciences,University of Gothenburg,Chalmers tekniska högskola,Chalmers University of Technology
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- Bech-Hanssen, Odd, 1956 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,University of Gothenburg
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(creator_code:org_t)
- 2009-07-12
- 2007
- Engelska.
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Ingår i: Scand Cardiovasc J. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 41:1, s. 12-8
- Relaterad länk:
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- OBJECTIVE: Aortic stenosis (AS) patients are often severely symptomatic at the time of aortic valve replacement (AVR). We wanted to investigate doctors' delay and its impact on outcome. DESIGN: AS patients undergoing AVR (n = 422) were included. Clinical and echocardiographic data at the time of diagnosis and preoperatively were noted. The risk of death after AVR was estimated using Poisson regression, incorporating age, gender, coronary artery disease, NYHA III/IV and time on the waiting list for AVR. RESULTS: The age (mean+/-SD) was 71+/-8.6 years, 45% were women, and 48% were in NYHA III/IV. 55% underwent AVR within one year of diagnosis, indicating late diagnosis. The time from referral to AVR (median, range) was 112 (1-803) days. NYHA III/IV independently predicted mortality (hazard ratio 1.76, 95% CI 1.28-2.43, p = 0.0005). The time from referral to AVR influenced the risk of death immediately after operation (p = 0.0083). CONCLUSION: Late diagnosis and late referral for AVR are common, and negatively influence outcome in patients with AS. Delay in surgery after referral increase the mortality immediately after AVR.
Nyckelord
- Aged
- Aortic Valve Stenosis/*diagnosis/mortality/physiopathology/*surgery
- Coronary Angiography
- Female
- Follow-Up Studies
- *Heart Valve Prosthesis Implantation
- Humans
- Kaplan-Meiers Estimate
- Male
- Odds Ratio
- Poisson Distribution
- Predictive Value of Tests
- Prognosis
- *Referral and Consultation
- Research Design
- Retrospective Studies
- Risk Assessment
- Severity of Illness Index
- Sweden/epidemiology
- Time Factors
- *Waiting Lists
- *Waiting Lists
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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