延迟诊断和急性大动脉解剖的结果:为期10年的单中心回顾性研究
Suluck Kanoksirirat1, Adisak Nithimathachoke1
1Department of Emergency Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Open access emergency medicine : OAEM
|May 15, 2025
概括
急性大动脉解剖 (AAD) 呈现变化,异型症状并不总是导致延迟诊断. 然而,异常的胸部X射线与AAD患者的较高死亡率有关.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 放射学 放射学是一门学科.
背景情况:
- 急性大动脉解剖 (AAD) 是一种罕见的,危及生命的疾病,具有不同的临床表现.
- 错误诊断是常见的,由于非典型的症状,突出需要更好的诊断策略.
研究的目的:
- 为了研究AAD的临床表现.
- 探索临床特征,延迟诊断和住院死亡率之间的关联.
主要方法:
- 在泰国 (2011-2020年) 对103名患有AAD的患者进行了回顾性图表审查.
- 对基线特征,临床表现,成像检测结果和延迟诊断 (>4小时) 的分析.
主要成果:
- 常见的症状包括腹部 (36.9%) 和胸部疼痛 (24.3%).
- 发现了非典型的无痛症状 (呼吸不全,意识变化,昏迷).
- 延迟诊断发生在27.2%的病例中,与正常压力,CAD病史和多发性溢血有关.
- 异常的胸部影像是住院死亡的主要风险因素 (22.3%),而不是延迟诊断.
结论:
- 泰国城市的ADD发病率为每10万患者年32.4.
- 高怀疑对于及时诊断ADD至关重要,即使有异常症状.
- 异常的胸部X射线发现与较差的AAD预后相关.
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