초록접수 현황
| 20F-179 | 구연 발표 |
Centralization of Patients with Ruptured Abdominal Aortic Aneurysm : Time Consuming or Life Saving ?
Tae-Hoon Kim1, Ha Lee1, Myeong su Kim1, Seungjun Song2, Wan Kee Kim2, Suk-Won Song1, Kyung-Jong Yoo3
1 Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
2 Department of Thoracic and Cardiovascular Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
3 Department of Thoracic and Cardiovascular Surgery, Cardiovascular Hospital, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
2 Department of Thoracic and Cardiovascular Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
3 Department of Thoracic and Cardiovascular Surgery, Cardiovascular Hospital, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : Our aim was to assess the impact of centralization on the outcomes of patients undergoing ruptured abdominal aortic aneurysm repair in single center experience.
Methods : Between 2008 and 2020, 139 patients with ruptured abdominal aortic aneurysm (rAAA) was reviewed. Of these, 107 patients (Group S) survived and discharged and 32 patients (Group D) died. Time interval between symptom and operation, transferred time and preoperative loss of consciousness and cardiac arrest was evaluated. Vancouver scoring system (VSS), which is ex / 1 + ex, where x = −3.44 + age (years) × 0.062 + loss of consciousness (LOC, yes = 1; no = −1) × 1.14 + cardiac arrest (yes = 1; no = −1) × 0.6 was calculated to stratify rAAA patients.
Results : Seven patients died before surgery and postoperative mortality was 18.9% (25 patients of 132 patients). Median time from symptom to emergency room and emergency room to operation were 5.4 and 0.6 hrs, respectively. Color map and table regarding baseline characteristics demonstrated that there was no correlation between location of transferring hospital, time interval from symptom to operation (hrs) and in-hospital mortality (Table 1 and Figure 1). Furthermore, multivariable logistic regression revealed that preoperative cardiac arrest, LOC and age were the only significant risk factors for in-hospital mortality.
Conclusion : There was no significant relation between ‘transferred time’/’time interval from symptom to operation’ and in-hospital mortality in patients with rAAA. Centralization of patients with rAAA to highly experienced center within 5-6 hrs seems to be reasonable.
Methods : Between 2008 and 2020, 139 patients with ruptured abdominal aortic aneurysm (rAAA) was reviewed. Of these, 107 patients (Group S) survived and discharged and 32 patients (Group D) died. Time interval between symptom and operation, transferred time and preoperative loss of consciousness and cardiac arrest was evaluated. Vancouver scoring system (VSS), which is ex / 1 + ex, where x = −3.44 + age (years) × 0.062 + loss of consciousness (LOC, yes = 1; no = −1) × 1.14 + cardiac arrest (yes = 1; no = −1) × 0.6 was calculated to stratify rAAA patients.
Results : Seven patients died before surgery and postoperative mortality was 18.9% (25 patients of 132 patients). Median time from symptom to emergency room and emergency room to operation were 5.4 and 0.6 hrs, respectively. Color map and table regarding baseline characteristics demonstrated that there was no correlation between location of transferring hospital, time interval from symptom to operation (hrs) and in-hospital mortality (Table 1 and Figure 1). Furthermore, multivariable logistic regression revealed that preoperative cardiac arrest, LOC and age were the only significant risk factors for in-hospital mortality.
Conclusion : There was no significant relation between ‘transferred time’/’time interval from symptom to operation’ and in-hospital mortality in patients with rAAA. Centralization of patients with rAAA to highly experienced center within 5-6 hrs seems to be reasonable.
책임저자: Suk-Won Song
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Tae-Hoon Kim , E-mail : airtech2@yuhs.ac