Why the study?
Does an early rehabilitation clinical pathway reduce complications and mortality in patients with uncomplicated type B acute aortic dissection compared to conventional therapy?
Does an early rehabilitation clinical pathway reduce complications and mortality in patients with uncomplicated type B acute aortic dissection compared to conventional therapy?
An early rehabilitation clinical pathway for uncomplicated type B acute aortic dissection reduces respiratory complications and delirium without increasing early mortality compared to traditional prolonged bed rest.
May reduce complications without excess mortality in type B dissection; leaves open randomized confirmation before practice change.
BACKGROUND: 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.
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Niino et al. (2009) studied this question.
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