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To identify factors associated with delays in diagnosis and treatment of acute aortic dissection, researchers reviewed data for almost 900 patients in the International Registry of Acute Aortic Dissection. During 2000–2007, the median time from emergency department arrival to diagnosis was 4.2 hours and from diagnosis to arrival in the operating room was 4.0 hours.
As expected, transfer from another hospital was associated with delay. Other factors associated with longer times to diagnosis, surgery, or both included female sex, congestive heart failure, and electrocardiogram findings consistent with acute myocardial infarction. Hypotension, shock, cardiac tamponade, and limb ischemia were associated with shorter times. Time to diagnosis was …