Clinical Outcomes of Direct Interhospital Transfers of Patients with Acute Aortic Syndrome Led by Advanced Practice Nurses

Abstract

Purpose This study aimed to evaluate the clinical outcomes of direct interhospital transfers (IHTs) of patients with acute aortic syndrome (AAS) led by advanced practice nurses (APNs). Methods From September 2014 to June 2017, the study retrospectively investigated 183 patients with AAS who were transferred to a high-volume tertiary hospital. Results One hundred forty-eight (81%) patients were admitted through direct IHTs, and 35 (19%) patients were admitted through non-direct IHTs. The direct IHT group had a significantly shorter time from symptom onset to hospital arrival than the non-direct IHT group (11.4 vs. 32.1 h, p=.043). There were no significant differences in other clinical outcomes, such as peri-transfer status, mortality, hospital length of stay, and readmission, between the two groups. In the direct IHT group, 55% of transfers were led by APNs. There was no significant difference in outcomes between APN- and physician-led transfers. Conclusions Implementation of direct IHTs markedly shortened the time from symptom onset to hospital arrival in patients with AAS. Finally, direct IHTs can potentially improve the outcomes of patients with AAS, a condition with time-dependent mortality and morbidity. In addition, APNs can effectively lead the direct IHT of patients with AAS. Key Words: Transfer, Nurse practitioner, Aortic aneurysm, Dissection, Treatment outcome 주요어: ì „ì›, ì „ë¬¸ê°„í˜¸ì‚¬, 대동맥류, 박리, 치료 ê²°ê³¼