Impact of Geographic Proximity on Survival in Stanford Type A Aortic Dissection Patients Undergoing Surgical Repair: A Single-Center Observational Study
Presented During:
Thursday, April 25, 2024: 5:38PM - 7:00PM
Sheraton Times Square
Posted Room Name:
Central Park
Abstract No:
P0154
Submission Type:
Abstract Submission
Authors:
Qianyun Luo (1), Stephen Huddleston (1), Qianyun Luo (1), Renxi Li (2), Ranjit John (1), Sara Shumway (3), Matthew Soule (1), K. Joshua Wong (1), Rochus Voeller (4), Andrew Shaffer (1), Rosemary Kelly (1)
Institutions:
(1) University of Minnesota Medical Center, Minneapolis, MN, (2) N/A, N/A, (3) Univ of Minnesota Medical Center, Minneapolis, MN, (4) University of Minnesota Medical Center, United States
Submitting Author:
Qianyun Luo
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University of Minnesota Medical Center
University of Minnesota Medical Center
Co-Author(s):
Stephen Huddleston
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University of Minnesota Medical Center
University of Minnesota Medical Center
Qianyun Luo
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University of Minnesota Medical Center
University of Minnesota Medical Center
Renxi Li
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*Ranjit John
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University of Minnesota Medical Center
University of Minnesota Medical Center
*Sara Shumway
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Univ of Minnesota Medical Center
Univ of Minnesota Medical Center
Matthew Soule
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University of Minnesota Medical Center
University of Minnesota Medical Center
K. Joshua Wong
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University of Minnesota Medical Center
University of Minnesota Medical Center
Rochus Voeller
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University of Minnesota Medical Center
University of Minnesota Medical Center
Andrew Shaffer
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University of Minnesota Medical Center
University of Minnesota Medical Center
*Rosemary Kelly
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University of Minnesota Medical Center
University of Minnesota Medical Center
Presenting Author:
Stephen Huddleston
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Abstract:
Objective: Stanford Type A aortic dissection (TAAD) is a life-threatening cardiovascular emergency necessitating immediate intervention; however, the correlation between travel distance to healthcare facilities offering surgical repair and clinical outcomes has not been examined. This study aims to investigate whether geographical proximity to medical care significantly affects patient survival.
Methods: Patients with TAAD who underwent surgical repair between 2011 and the second quarter of 2023 were identified in this single-center observational study. Patients were categorized into groups based on the distance from their residential zip code to the university hospital. Survival analysis employed the Kaplan-Meier method, and the influence of distance was assessed using the Cox proportional hazard model. Log rank test was done for multiple comparison to evaluate survival difference between the groups.
Results: 240 patients with TAAD who underwent surgical repair were identified. Median age was 61.1 (IQR 51.2-72.2), with 32.4% female. Median distance from patient's residential zip code to the university hospital is 25.4 miles (IQR 10.4-121.6 miles). Discharge mortality was 5.3%, 4.3%, 4.2%, 5.8% for patients who reside within 25 miles, 25-50 miles, 50-100 miles, and more than 100 miles from the hospital (p = 0.99). Log rank multiple comparison test revealed no difference between the four groups with all p-value greater than 0.50. Similarly, 30-day mortality for patients who reside within 25 miles, 25-50 miles, 50-100 miles, and more than 100 miles from the hospital was 7.3%, 12.5%, 3.8%, 6.3% respectively (p = 0.68). No difference was found from the log rank multiple comparison test (p> 0.46).
Conclusions: This study found no significant association between geographical proximity to the medical facility providing surgical repair and patient survival outcomes in cases of TAAD undergoing surgical repair. These results suggest that although access to timely medical care is important, it is not a limiting factor in achieving favorable clinical outcomes in this single-center setting.
Methods: Patients with TAAD who underwent surgical repair between 2011 and the second quarter of 2023 were identified in this single-center observational study. Patients were categorized into groups based on the distance from their residential zip code to the university hospital. Survival analysis employed the Kaplan-Meier method, and the influence of distance was assessed using the Cox proportional hazard model. Log rank test was done for multiple comparison to evaluate survival difference between the groups.
Results: 240 patients with TAAD who underwent surgical repair were identified. Median age was 61.1 (IQR 51.2-72.2), with 32.4% female. Median distance from patient's residential zip code to the university hospital is 25.4 miles (IQR 10.4-121.6 miles). Discharge mortality was 5.3%, 4.3%, 4.2%, 5.8% for patients who reside within 25 miles, 25-50 miles, 50-100 miles, and more than 100 miles from the hospital (p = 0.99). Log rank multiple comparison test revealed no difference between the four groups with all p-value greater than 0.50. Similarly, 30-day mortality for patients who reside within 25 miles, 25-50 miles, 50-100 miles, and more than 100 miles from the hospital was 7.3%, 12.5%, 3.8%, 6.3% respectively (p = 0.68). No difference was found from the log rank multiple comparison test (p> 0.46).
Conclusions: This study found no significant association between geographical proximity to the medical facility providing surgical repair and patient survival outcomes in cases of TAAD undergoing surgical repair. These results suggest that although access to timely medical care is important, it is not a limiting factor in achieving favorable clinical outcomes in this single-center setting.
Aortic Symposium:
Dissection
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