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[Discuss Many to Benefit More - Five-Year Analysis of a Multidisciplinary Aortic Board]
Katrin Meisenbacher1, Uwe Geis1, Hans-Ulrich Kauczor2
1Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Deutschland.
Zentralblatt Fur Chirurgie
|March 25, 2020
Summary
Multidisciplinary aortic boards (mAB) effectively filter patients towards conservative treatment, but many patients recommended for surgery do not receive it. Improving mAB performance requires a central management office and registry for better aortic disease management.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Medical Decision Making
Background:
- Multidisciplinary aortic boards (mAB) are crucial for managing complex aortic pathologies.
- Evaluating mAB performance is essential for optimizing patient care pathways.
Purpose of the Study:
- To assess the patient volume and discipline-specific contributions to a maximum care hospital's mAB.
- To review treatment indications and patient allocation decisions made by the mAB.
- To identify areas for improvement in mAB function and patient management.
Main Methods:
- Retrospective analysis of patients discussed in the mAB from 01/2014 to 12/2018.
- Inclusion of data from Heidelberg University Hospital's Vascular and Endovascular Surgery, Cardiac Surgery, and Radiology departments.
- Review of patient demographics, treatment indications (conservative vs. surgical), and actual therapies received.
Main Results:
- 344 patients were discussed over five years (median 71/year), predominantly from Vascular Surgery (76%).
- Surgical treatment was indicated in 45% of cases, with a nearly equal distribution between Vascular and Cardiac Surgery referrals.
- A significant proportion (39%) of patients indicated for surgery did not receive the recommended treatment.
Conclusions:
- The mAB plays a key role in directing patients towards conservative management.
- The high volume from outpatient sectors highlights the mAB's reliance on external referrals.
- A central management office and registry are recommended to enhance mAB effectiveness and ensure adherence to surgical recommendations.
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