Strübing Felix, Laurich Annette, Weiss Christel, Schönberg Stefan, Kneser Ulrich, Sadick Maliha
Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Hand and Plastic Surgery, University of Heidelberg, Ludwigshafen, Germany.
Department of Medical Statistics and Biomathematics and Data Processing, University Medical Center Mannheim, Faculty for Clinical Medicine, University of Heidelberg, Mannheim, Germany.
Acta Radiol. 2023 Apr;64(4):1712-1717. doi: 10.1177/02841851221130869. Epub 2022 Oct 13.
Vascular malformations are rare diseases that are best managed in multidisciplinary vascular anomaly centers (VAC). So far, there are few published data on the logistic structure, patient allotment, and internal workflow in an interdisciplinary VAC.
To demonstrate the referral structure and patient allotment in a European VAC.
A retrospective cohort study was conducted. All patients treated in the VAC since its establishment in April 2014 until June 2020 were identified. A total of 461 patients were included in this study.
Most often, a venous malformation was diagnosed (49.9%), followed by arteriovenous malformations (8.7%) and syndromal vascular malformations (8.2%). Only 45.1% of referral diagnoses were correct. Of referrals, 35.1% were internal on-campus references, 28.0% were external references through physicians in private practice, and 19.7% came via external cooperating hospitals. Of the patients, 17.1% were self-admissions without a referral.
The most important referring clinics are internal medicine, pediatric, and vascular surgery. A substantial proportion of referrals came from private practices. Recruiting these cooperation partners should be considered a high priority when establishing a new VAC. The rate of misdiagnosis is high, and more education of fellow clinicians is urgently needed. Therefore, patients with vascular malformations should be referred to and treated in dedicated centers for vascular anomalies.
血管畸形是罕见疾病，在多学科血管异常中心（VAC）进行最佳管理。到目前为止，关于跨学科VAC的后勤结构、患者分配和内部工作流程的已发表数据很少。
展示欧洲一个VAC的转诊结构和患者分配情况。
进行了一项回顾性队列研究。确定了自2014年4月VAC成立至2020年6月在该中心接受治疗的所有患者。本研究共纳入461例患者。
最常诊断出的是静脉畸形（49.9%），其次是动静脉畸形（8.7%）和综合征性血管畸形（8.2%）。只有45.1%的转诊诊断是正确的。在转诊中，35.1%是校内内部转诊，28.0%是通过私人执业医生的外部转诊，19.7%是通过外部合作医院转诊。在患者中，17.1%是无转诊的自行就诊患者。
最重要的转诊科室是内科、儿科和血管外科。相当一部分转诊来自私人诊所。在建立新的VAC时，应将招募这些合作伙伴视为高度优先事项。误诊率很高，迫切需要对临床同行进行更多培训。因此，血管畸形患者应转诊至专门的血管异常中心进行治疗。
