Spanish Acute Aortic Syndrome Study (RESA). Better diagnosis is not reflected in reduced mortality.
OBJECTIVE
Because acute aortic syndrome (AAS) is associated with high mortality, early diagnosis and treatment are vital. The aim of the Spanish Acute Aortic Syndrome Study (RESA) was to investigate the effectiveness of current treatment of AAS in a broad range of tertiary care hospitals in Spain.


METHODS
Between January 2005 and December 2007, 24 tertiary care hospitals reported data on 519 patients with AAS (78% male, mean age 61 +/- 13 years, range 20-92 years): 357 had type-A AAS and 162 had type B.


RESULTS
The time delay between symptom onset and diagnosis was <24 hours in 67% of cases and >72 hours in 11%. Some 80% of patients with type-A AAS were treated surgically. The interval between diagnosis and surgery was <24 hours in 90% of cases. In patients with type-B AAS, 34% received invasive treatment: 11% had surgery and 23% underwent endovascular procedures. Mortality during hospitalization in patients with type-A disease was 33% in those treated surgically and 71% in those treated medically. Mortality in patients with type-B disease was 17% with medical treatment, 27% with endovascular treatment and 50% with surgical treatment.


CONCLUSIONS
Despite significant advances in the diagnosis of AAS, in-hospital mortality remains high. The findings of this study are representative of a broad range of unselected patients undergoing treatment for the disease and support the need for continuing improvements in therapeutic approaches to AAS.
Evangelista
Arturo
A
Servicio de Cardiología, Hospital Vall d'Hebron, 08035 Barcelona, Spain. aevangel@vhebron.net
Padilla
Ferran
F
López-Ayerbe
Jordi
J
Calvo
Francisco
F
López-Pérez
José Manuel
JM
Sánchez
Violeta
V
Morís
César
C
Fernández-Tarrío
Rubén
R
San Román
José A
JA
Saura
Daniel
D
Nistal
Francisco
F
Alegret
Josep M
JM
Gallego
Pastora
P
Aguilar
Río
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D003625:Data Collection; D003952:Diagnostic Imaging; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult