Diagnostic and referral delay in patients with aortic stenosis is common and negatively affects outcome
Artikel i vetenskaplig tidskrift, 2007

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.

*Waiting Lists

Coronary Angiography

Male

Research Design

*Referral and Consultation

Risk Assessment

*Heart Valve Prosthesis Implantation

Poisson Distribution

Odds Ratio

Severity of Illness Index

Retrospective Studies

Female

Follow-Up Studies

Prognosis

Time Factors

Sweden/epidemiology

Humans

Aged

Kaplan-Meiers Estimate

Aortic Valve Stenosis/*diagnosis/mortality/physiopathology/*surgery

Predictive Value of Tests

Författare

Peter Gjertsson

Göteborgs universitet

Kenneth Caidahl

Göteborgs universitet

Anders Odén

Göteborgs universitet

Chalmers, Matematiska vetenskaper

Odd Bech-Hanssen

Göteborgs universitet

Scandinavian Cardiovascular Journal

1401-7431 (ISSN) 1651-2006 (eISSN)

Vol. 41 1 12-8

Ämneskategorier

MEDICIN OCH HÄLSOVETENSKAP

DOI

10.1080/14017430601115935

PubMed

17365972