Analysis of mortality in patients with early diagnosis of acute aortic dissection

Abstract

Objective. The aim of this study was to analyze the frequency of acute aortic dissection, its clinical manifestations, treatment modalities, and mortality. Methods. During the years of 2008 and 2009 twenty six patients with acute aortic dissection (14 women with mean age 61.9±14.8 years and 12 men, mean age 64.8±10.0 years) were treated in the Internal medicine department of the Center for Emergency Medicine, Clinical Center 'Kragujevac'. Results. The predominant symptoms in the majority of patients were pain in the chest and abdomen, but five patients were dominated by symptoms of central nervous system (headache, speech disturbances, hemiparesis, loss of consciousness, etc.). The working diagnosis of aortic dissection was made after physical examination in seven patients (five had already had aneurysms of the aorta), and after an ultrasound examination in fourteen patients. Only two patients were operated in the reference institution outside the Clinical Center 'Kragujevac'. In nine patients the situation stabilized with medication treatment, and lethal outcome was recorded in 15 patients (57.7%), eleven of whom in the Center for Emergency Medicine - within the first six hours of hospitalization, and four patients in other clinics of CC 'Kragujevac'. Conclusion. Patients with acute aortic dissection need to be diagnosed and hospitalized in a multidisciplinary and standardized approach so that the critical period between making the diagnosis and the surgical treatment is shorter and the hospital service and care for the patients is better in terms of adequate transport to the institution in which urgent surgical interventions can be performed.