Delay to Transfer Predicts a Worse Prognosis for Uncomplicated Type B Aortic Dissection

Acute type B aortic dissections (TBADs) can become complicated, necessitating surgical repair. Characterizing the predictors for, and outcomes of, TBADs that complicated in a delayed fashion be used to inform treatment of patients who initially presented with uncomplicated TBADs. All acute TBAD tertiary center from 2015 2019 were included. The divided into (icTBAD; 0-24 hours symptom onset), (dcTBAD; 25 14 days), (ucTBAD) groups. criteria for dissection rupture, malperfusion, and/or rapid growth. demographics, patient history, timing presentation, imaging findings, clinical compared between Of 120 identified, 27 (22%) (aortic n = 9; 18); 21 (18%) developed complications 3; 14; growth, 4) median 7.0 days (interquartile range, 4.0-9.0 days) onset. 72 (60%) remained at day 14. Overall, 111 (93%) had as transfers outside hospitals (icTBAD, 25; dcTBAD, 21; ucTBAD, 65). these patients, those dcTBAD more likely have prolonged delay presentation hospital transfer ucTBAD (n 21, mean ± standard deviation delay, 2.81 3.15 days; 72, 0.26 0.82 P ≤ .001). dcTBADs, 38% no high-risk features on initial studies. Patients dcTBADs required significantly longer length stay (median, 12 interquartile 9.0-17.0 icTBADs 5.0-12.0 ucTBADs 6.0; 5.0-11.5 .006). In-hospital mortality was greater than (9.5% vs 0%; .047). not different icTBAD 11%). Delay associated TBAD, leading intervention. dcTBADS an increased in-hospital mortality. These data suggest benefit regionalized centers excellence care protocols expedite