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Outcomes before and after the Implementation of a Critical Pathway for Patients with Acute Aortic Disease
DC Field | Value | Language |
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dc.contributor.author | 고영국 | - |
dc.contributor.author | 김민정 | - |
dc.contributor.author | 박인철 | - |
dc.contributor.author | 신규철 | - |
dc.contributor.author | 이혜선 | - |
dc.contributor.author | 주현철 | - |
dc.date.accessioned | 2017-10-26T07:25:35Z | - |
dc.date.available | 2017-10-26T07:25:35Z | - |
dc.date.issued | 2016 | - |
dc.identifier.issn | 0513-5796 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/152011 | - |
dc.description.abstract | PURPOSE: Acute aortic diseases, such as aortic dissection and aortic aneurysm, can be life-threatening vascular conditions. In this study, we compared outcomes before and after the implementation of a critical pathway (CP) for patients with acute aortic disease at the emergency department (ED). MATERIALS AND METHODS: This was a retrospective observational cohort study. The CP was composed of two phases: PRE-AORTA for early diagnosis and AORTA for prompt treatment. We compared patients who were diagnosed with acute aortic disease between pre-period (January 2010 to December 2011) and post-period (July 2012 to June 2014). RESULTS: Ninety-four and 104 patients were diagnosed with acute aortic disease in the pre- and post-periods, respectively. After the implementation of the CP, 38.7% of acute aortic disease cases were diagnosed via PRE-AORTA. The door-to-CT time was reduced more in PRE-AORTA-activated patients [71.0 (61.0, 115.0) min vs. 113.0 (56.0, 170.5) min; p=0.026]. During the post-period, more patients received emergency intervention than during the pre-period (22.3% vs. 36.5%; p=0.029). Time until emergency intervention was reduced in patients, who visited the ED directly, from 378.0 (302.0, 489.0) min in the pre-period to 200.0 (170.0, 299.0) min in the post-period (p=0.001). The number of patients who died in the ED declined from 11 to 4 from the pre-period to the post-period. Hospital mortality decreased from 26.6% to 14.4% in the post-period (p=0.033). CONCLUSION: After the implementation of a CP for patients with acute aortic disease, more patients received emergency intervention within a shorter time, resulting in improved hospital mortality. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | Yonsei University | - |
dc.relation.isPartOf | YONSEI MEDICAL JOURNAL | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.subject.MESH | Acute Disease | - |
dc.subject.MESH | Adult | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | Aneurysm, Dissecting/diagnosis | - |
dc.subject.MESH | Aneurysm, Dissecting/mortality | - |
dc.subject.MESH | Aneurysm, Dissecting/surgery* | - |
dc.subject.MESH | Aorta | - |
dc.subject.MESH | Aortic Aneurysm/diagnosis | - |
dc.subject.MESH | Aortic Aneurysm/mortality | - |
dc.subject.MESH | Aortic Aneurysm/surgery* | - |
dc.subject.MESH | Aortic Diseases/diagnosis | - |
dc.subject.MESH | Aortic Diseases/mortality | - |
dc.subject.MESH | Aortic Diseases/surgery* | - |
dc.subject.MESH | Critical Pathways* | - |
dc.subject.MESH | Emergency Service, Hospital/organization & administration* | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Hospital Mortality | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Outcome and Process Assessment (Health Care) | - |
dc.subject.MESH | Postoperative Complications/mortality | - |
dc.subject.MESH | Republic of Korea/epidemiology | - |
dc.subject.MESH | Retrospective Studies | - |
dc.subject.MESH | Time Factors | - |
dc.subject.MESH | Treatment Outcome | - |
dc.subject.MESH | Vascular Surgical Procedures/methods* | - |
dc.title | Outcomes before and after the Implementation of a Critical Pathway for Patients with Acute Aortic Disease | - |
dc.type | Article | - |
dc.publisher.location | Korea (South) | - |
dc.contributor.college | College of Medicine | - |
dc.contributor.department | Dept. of Internal Medicine | - |
dc.contributor.googleauthor | Kyu Chul Shin | - |
dc.contributor.googleauthor | Hye Sun Lee | - |
dc.contributor.googleauthor | Joon Min Park | - |
dc.contributor.googleauthor | Hyun-Chel Joo | - |
dc.contributor.googleauthor | Young-Guk Ko | - |
dc.contributor.googleauthor | Incheol Park | - |
dc.contributor.googleauthor | Min Joung Kim | - |
dc.identifier.doi | 10.3349/ymj.2016.57.3.626. | - |
dc.contributor.localId | A00470 | - |
dc.contributor.localId | A01628 | - |
dc.contributor.localId | A04965 | - |
dc.contributor.localId | A03312 | - |
dc.contributor.localId | A03960 | - |
dc.contributor.localId | A00127 | - |
dc.relation.journalcode | J02813 | - |
dc.identifier.eissn | 1976-2437 | - |
dc.identifier.pmid | 26996561 | - |
dc.subject.keyword | Critical pathway | - |
dc.subject.keyword | aorta | - |
dc.subject.keyword | aortic aneurysm | - |
dc.subject.keyword | aortic dissection | - |
dc.subject.keyword | clinical protocol | - |
dc.subject.keyword | mortality | - |
dc.contributor.alternativeName | Ko, Young Guk | - |
dc.contributor.alternativeName | Kim, Min Joung | - |
dc.contributor.alternativeName | Park, In Cheol | - |
dc.contributor.alternativeName | Shin, Kyu Chul | - |
dc.contributor.alternativeName | Lee, Hye Sun | - |
dc.contributor.alternativeName | Joo, Hyun Chel | - |
dc.contributor.affiliatedAuthor | Kim, Min Joung | - |
dc.contributor.affiliatedAuthor | Park, In Cheol | - |
dc.contributor.affiliatedAuthor | Shin, Kyu Chul | - |
dc.contributor.affiliatedAuthor | Lee, Hye Sun | - |
dc.contributor.affiliatedAuthor | Joo, Hyun Chel | - |
dc.contributor.affiliatedAuthor | Ko, Young Guk | - |
dc.citation.volume | 57 | - |
dc.citation.number | 3 | - |
dc.citation.startPage | 626 | - |
dc.citation.endPage | 634 | - |
dc.identifier.bibliographicCitation | YONSEI MEDICAL JOURNAL, Vol.57(3) : 626-634, 2016 | - |
dc.date.modified | 2017-10-24 | - |
dc.identifier.rimsid | 46333 | - |
dc.type.rims | ART | - |
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