Document Detail


Optimal clinical pathway for the patient with type B acute aortic dissection.
MedLine Citation:
PMID:  19106462     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The traditional medical treatment for type B acute aortic dissection (AAD) is widely accepted, but the optimal clinical pathway has not been confirmed. Methods and Results From admissions over the past 12 years, 210 patients with uncomplicated type B AAD were divided into 2 groups: Conventional therapy group (CG) of 90 who were treated by 7 days of bed rest and intravenous antihypertensive agents and the Clinical pathway group (CPG) of 120 who were treated by early rehabilitation. In the CPG, patients were administered oral medication from the first day after onset and took a short walk from the third day after onset. The incidence of respiratory complications, and of delirium, was significantly decreased in the CPG. Early mortality was similar: 3.3% and 2.5%, respectively. The diameter of the aorta had not enlarged in either group 1 month later. Conclusions The clinical pathway of treatment for uncomplicated type B AAD was safer and better for preventing early complications and cost benefit.
Authors:
Tetsuya Niino; Mitsumasa Hata; Akira Sezai; Isamu Yoshitake; Satoshi Unosawa; Kazuma Shimura; Shunji Osaka; Kazutomo Minami
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-12-24
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  73     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-23     Completed Date:  2009-04-21     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  264-8     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. tenino@med.nihon-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aneurysm, Dissecting / economics,  rehabilitation*,  therapy*
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Aortic Aneurysm / economics,  rehabilitation*,  therapy*
Calcium Channel Blockers / therapeutic use
Cost-Benefit Analysis
Critical Pathways*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications / prevention & control
Retrospective Studies
Walking
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Calcium Channel Blockers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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