Abstract

Objectives: This study aims to evaluate the effect of referral and transfer of patients with acute type A aortic dissection (AAAD) and
treatment outcomes in the emergency setting.
Patients and methods: A total of 131 patients (75 males, 56 females; mean age 52.2±13.1 years; range, 18 to 80 years) who underwent surgery
due to AAAD in the emergency setting in our center between January 2010 and December 2017 were included in the study. The patients
were divided into two groups as those who were diagnosed with AAAD in another health care facility and transferred to our hospital (Group
A, n=65) and those who were diagnosed in our emergency room (Group B, n=66).
Results: The rate of postoperative neurological complications was 24.6% in Group A and 12.1% in Group B (p=0.74). The postoperative
persistent neurological deficit rate was 10.5% in Group A and 9% in Group B (p=0.456). The overall hospital mortality rate was 23.2%
(p=0.310). Hemodynamic instability, age, and cardiopulmonary bypass time were independent risk factors for overall hospital mortality.
Conclusion: Although the patients diagnosed with AAAD in another healthcare facility were hemodynamically unstable compared to those
diagnosed in our center, the mortality and morbidity rates did not significantly differ. Based on our study results, we recommend transferring
such patients to a reference hospital.

Key words: Mortality, referral, transfer, type A aortic dissection.