Key result
Canadian survey reveals heterogeneous thoracic aortic disease care, with only 54% reporting multidisciplinary teams.
Why the study?
Multiple specialties treat thoracic aortic disease resulting in varied care pathways, and characterization of these care models was needed to guide health policy.
Cross-Sectional (n=248)
Yes
There is significant heterogeneity in the care pathways for thoracic aortic disease in Canada, highlighting the need for standardized multidisciplinary aortic teams.
Highlights mismatch between preferred and available aortic teams; leaves open impact on thoracic aortic outcomes.
BACKGROUND: Several specialties treat thoracic aortic disease, resulting in multiple patient care pathways. This study aimed to characterize these varied care models to guide health policy. METHODS: A 57-question e-survey was sent to staff cardiac surgeons, cardiologists, interventional radiologists, and vascular surgeons at 7 Canadian medical societies. RESULTS: For 914 physicians, the response rate was 76% (86 of 113) for cardiac surgeons, 40% (58 of 146) for vascular surgeons, 24% (34 of 140) for radiologists, and 14% (70 of 515) for cardiologists. Several services admitted type B dissections (vascular 37%, cardiology 31%, cardiac 18%, other 7%), and care was heterogeneous. Ownership of disease management was overestimated relative to the perspective of the other specialties. Type A dissection admissions and treatment were more uniform, but emergent call coverage varied. A 24/7 aortic specialist on-call schedule was present only 4% of the time. "Aortic" case rounds promoted attendance by a broader aortic specialty contingency relative to rounds that were specialty specific. Although 89% of respondents felt an aortic team was best for patient care, only 54% worked at an institution with an aortic team present, and only 28% utilized an aortic clinic. Questions designed to define an aortic team derived 63 different combinations. CONCLUSIONS: Thoracic aortic disease follows a network of undefined and variable care pathways, despite its high-risk population in need of complex treatment considerations. Multidisciplinary aortic teams and clinics exist in low volume, and the "aortic team" remains an obscure construct. A multispecialty initiative to define the aortic team and outline standardized navigation pathways within the health systems hospitals is advocated.
No takes yet. Share an insight, caveat, or question.
McClure et al. (2021) conducted a cross-sectional in Thoracic aortic disease (n=248). A nationwide Canadian survey revealed highly heterogeneous care pathways for thoracic aortic disease, with only 54% of physicians working at institutions with a multidisciplinary aortic team.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: