論文

査読有り 国際誌
2020年3月23日

Association between prehospital transfer distance and surgical mortality in emergency thoracic aortic surgery.

The Journal of thoracic and cardiovascular surgery
  • Yu Izumisawa
  • ,
  • Hideki Endo
  • ,
  • Nao Ichihara
  • ,
  • Arata Takahashi
  • ,
  • Kan Nawata
  • ,
  • Hiroshi Shiraishi
  • ,
  • Hiroaki Miyata
  • ,
  • Noboru Motomura

担当区分
責任著者
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.jtcvs.2020.03.043
出版者・発行元
Elsevier {BV}

OBJECTIVE: To examine whether there is an association between prehospital transfer distance and surgical mortality in emergency thoracic aortic surgery. METHODS: A retrospective cohort study using a national clinical database in Japan was conducted. Patients who underwent emergency thoracic aortic surgery from January 1, 2014, to December 31, 2016, were included. Patients with type B dissection were excluded. A multilevel logistic regression analysis was performed to examine the association between prehospital transfer distance and surgical mortality. In addition, an instrumental variable analysis was performed to address unmeasured confounding. RESULTS: A total of 12,004 patients underwent emergency thoracic aortic surgeries at 495 hospitals. Surgical mortality was 13.8%. The risk-adjusted mortality odds ratio for standardized distance (mean 12.8 km, standard deviation 15.2 km) was 0.94 (95% confidence interval, 0.87-1.01; P = .09). Instrumental variable analysis did not reveal a significant association between transfer distance and surgical mortality as well. CONCLUSIONS: No significant association was found between surgical mortality and prehospital transfer distance in emergency thoracic aortic surgery cases. Suspected cases of acute thoracic aortic syndrome may be transferred safely to distant high-volume hospitals.

リンク情報
DOI
https://doi.org/10.1016/j.jtcvs.2020.03.043
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32331819

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