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Göteborgs universitets publikationer

Diagnostic and referral delay in patients with aortic stenosis is common and negatively affects outcome

Författare och institution:
Peter Gjertsson (Institutionen för medicin, avdelningen för molekylär och klinisk medicin); Kenneth Caidahl (Institutionen för medicin, avdelningen för molekylär och klinisk medicin); Anders Odén (Institutionen för matematiska vetenskaper, Chalmers/GU); Odd Bech-Hanssen (Institutionen för medicin, avdelningen för molekylär och klinisk medicin)
Publicerad i:
Scand Cardiovasc J, 41 ( 1 ) s. 12-8
1401-7431 (Print)
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
OBJECTIVE: Aortic stenosis (AS) patients are often severely symptomatic at the time of aortic valve replacement (AVR). We wanted to investigate doctors' delay and its impact on outcome. DESIGN: AS patients undergoing AVR (n = 422) were included. Clinical and echocardiographic data at the time of diagnosis and preoperatively were noted. The risk of death after AVR was estimated using Poisson regression, incorporating age, gender, coronary artery disease, NYHA III/IV and time on the waiting list for AVR. RESULTS: The age (mean+/-SD) was 71+/-8.6 years, 45% were women, and 48% were in NYHA III/IV. 55% underwent AVR within one year of diagnosis, indicating late diagnosis. The time from referral to AVR (median, range) was 112 (1-803) days. NYHA III/IV independently predicted mortality (hazard ratio 1.76, 95% CI 1.28-2.43, p = 0.0005). The time from referral to AVR influenced the risk of death immediately after operation (p = 0.0083). CONCLUSION: Late diagnosis and late referral for AVR are common, and negatively influence outcome in patients with AS. Delay in surgery after referral increase the mortality immediately after AVR.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Aged, Aortic Valve Stenosis/*diagnosis/mortality/physiopathology/*surgery, Coronary Angiography, Female, Follow-Up Studies, *Heart Valve Prosthesis Implantation, Humans, Kaplan-Meiers Estimate, Male, Odds Ratio, Poisson Distribution, Predictive Value of Tests, Prognosis, *Referral and Consultation, Research Design, Retrospective Studies, Risk Assessment, Severity of Illness Index, Sweden/epidemiology, Time Factors, *Waiting Lists
Postens nummer:
Posten skapad:
2007-10-30 16:32
Posten ändrad:
2011-01-20 09:58

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