PMID- 19344577
OWN - NLM
STAT- MEDLINE
DCOM- 20090513
LR  - 20170214
IS  - 1708-5381 (Print)
IS  - 1708-5381 (Linking)
VI  - 17
IP  - 1
DP  - 2009 Jan-Feb
TI  - Effect of patient transfer on outcomes after open repair of ruptured abdominal 
      aortic aneurysms.
PG  - 9-14
AB  - Patients with ruptured abdominal aortic aneurysms (RAAAs) benefit from treatment 
      in high-volume facilities. This study explored the effect of patient transfer on 
      outcomes and the relationship between hemodynamic status and mortality. We 
      performed a retrospective review of 83 consecutive patients who had open repair 
      for RAAA at a single tertiary facility. The patients were divided into two groups 
      based on arrival in the local emergency department, "local" (n = 44) versus 
      "transfer" (n = 39) from an outside institution, and into three categories of 
      hemodynamic status: (a) no obtainable blood pressure, "pulseless"; (b) requiring 
      vasopressor support, "pressors"; and (c) no vasopressor support, "no pressors." 
      Thirty-day mortality was 21.4%. There was no difference in mortality between the 
      local (18.2%) and transfer (25.6%) patients (p = .41). There were no deaths 
      during transfer. There was no difference in the hemodynamic status of the 
      transfer versus the local group (p = .34). The mortality by category was 
      pulseless, 100% (3 of 3); pressors, 71.4% (10 of 14); and no pressors, 7.6% (5 of 
      66) (p < .0001). Actuarial survival was 66%, 64%, and 62% at 1, 3, and 5 years, 
      respectively. Patient transfer does not adversely affect mortality after RAAA 
      repair. Patients without a palpable pulse and those requiring hemodynamic support 
      have a significantly higher mortality.
FAU - Azizzadeh, Ali
AU  - Azizzadeh A
AD  - Department of Cardiothoracic and Vascular Surgery, University of Texas Health 
      Science Center, Memorial Hermann Heart and Vascular Institute, Houston, TX, USA. 
      Ali.Azizzadeh@uth.tmc.edu
FAU - Miller, Charles C 3rd
AU  - Miller CC 3rd
FAU - Villa, Martin A
AU  - Villa MA
FAU - Estrera, Anthony L
AU  - Estrera AL
FAU - Coogan, Sheila M
AU  - Coogan SM
FAU - Meiner, Sean T
AU  - Meiner ST
FAU - Safi, Hazim J
AU  - Safi HJ
LA  - eng
PT  - Journal Article
PL  - England
TA  - Vascular
JT  - Vascular
JID - 101196722
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Aneurysm, Abdominal/mortality/*surgery
MH  - Aortic Rupture/mortality/*surgery
MH  - Cardiology Service, Hospital
MH  - Emergencies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - *Patient Transfer
MH  - Retrospective Studies
MH  - Risk Assessment/methods
MH  - Survival Rate
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2009/04/07 09:00
MHDA- 2009/05/14 09:00
CRDT- 2009/04/07 09:00
PHST- 2009/04/07 09:00 [entrez]
PHST- 2009/04/07 09:00 [pubmed]
PHST- 2009/05/14 09:00 [medline]
AID - 10.2310/6670.2009.00006 [doi]
PST - ppublish
SO  - Vascular. 2009 Jan-Feb;17(1):9-14. doi: 10.2310/6670.2009.00006.