Results:

During the 18-month period December 2013–July 2015, 183 patients were transferred by a rapid transport system, including 148 (81%) patients transported by ground and 35 (19%) by air. Median distance traveled was 24 miles (range 3.6–316 miles); median transport time was 42 minutes (range 10–144 minutes). Two patients died during transport, one with a type A dissection, the other of a ruptured abdominal aortic aneurysm. There were 118 (66%) patients who received operative intervention. Median time to operation was 6 hours. Type B dissections had the longest median time to operation (45 hours), with system-related mortality of 1.9%; type A dissections had the shortest median time (3 hours), and a system-related mortality of 16%. Overall, system-related mortality was 15%. On univariate analysis, factors associated with system-related mortality were age ≥65 years (p = 0.026), coronary artery disease (p = 0.030), prior myocardial infarction (p = 0.049), prior coronary revascularization (p = 0.002), SVSCSS >8 (p < 0.001), abdominal pain (p = 0.002), systolic blood pressure <90 mm Hg at sending hospital (p = 0.001), diagnosis of aortic aneurysm (p = 0.013), systolic blood pressure <90 mm Hg in the intensive care unit (p < 0.001), and APACHE II score >10 (p = 0.004). Distance traveled and transport mode and duration were not associated with increased risk of system-related mortality. Only SVSCSS of >8 (odds ratio, 7.73; 95% confidence interval, 2.32-25.8; p = 0.001) was independently associated with an increase in system-related mortality on multivariate analysis.