Evaluating current acute aortic syndrome pathways: Collaborative Acute Aortic Syndrome Project (CAASP)
Jim Zhong1,2, Aminder A Singh3,4, Nawaz Z Safdar2,5
1Department of Diagnostic and Interventional Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
BJS Open
|September 19, 2024
Summary
Acute aortic syndrome diagnosis and treatment pathways were evaluated in 620 patients. Delays in diagnosis and treatment impact patient outcomes, highlighting areas for improved acute aortic syndrome care strategies.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Medical Imaging
Background:
- Acute aortic syndrome (AAS) diagnosis is complex, with significant perihospital mortality.
- Evaluating patient care pathways and timelines is crucial for improving outcomes.
Purpose of the Study:
- To assess current patient care pathways for acute aortic syndrome.
- To understand the chronology of AAS patient care from presentation to treatment.
Main Methods:
- Retrospective review of 620 consecutive AAS patients diagnosed via imaging across 15 UK sites.
- Data collected from January 2018 to June 2021, with 6-month follow-up.
- Coordinated by the UK National Interventional Radiology Trainee Research and Vascular and Endovascular Research Network.
Main Results:
- Type-A dissection (41.8%) and Type-B dissection (34.5%) were most common; 41.2% had complicated AAS.
- Median time to hospital presentation was 3.1 hours; time to imaging diagnosis was 3.2 hours.
- Delays in diagnosis and treatment, particularly interhospital transfers, were observed. Factors like age >70, complicated disease, and no critical care admission correlated with higher mortality.
Conclusions:
- This study provides longitudinal data linking diagnostic and treatment delays to clinical outcomes in AAS.
- Findings can inform research priorities to optimize AAS patient care pathways.
- Streamlining patient care is essential to reduce mortality associated with acute aortic syndrome.
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