Abstract:
BACKGROUND:Starting in December 2013, the Hospital Inpatient Quality Reporting Program included Clostridium difficile infection (CDI) rates as a new publically reported quality measure. Our goal was to review the trend, hospital variability in CDI rates, and associated risk factors and costs in vascular surgery. METHODS:The rates of CDI after major vascular procedures including aortic abdominal aneurysm (AAA) repair, carotid endarterectomy or stenting, lower extremity revascularization (LER), and LE amputation were identified using Nationwide Inpatient Sample database for 2000-2011. Risk factors associated with CDI were analyzed with hierarchical multivariate logistic regression. Extra costs, length of stay (LOS), and mortality were assessed for propensity-matched hospitalizations with and without CDI. RESULTS:During the study period, the rates of CDI after vascular procedures had increased by 74% from 0.6 in 2000 to 1.05% in 2011, whereas the case fatality rate was stable at 9-11%. In 2011, the highest rates were after ruptured aortic abdominal aneurysm (rAAA) repair (3.3%), followed by lower extremity amputations (2.3%) and elective open AAA (1.3%). The rates of CDI increased after all vascular procedures during the 12 years. The highest increase was after endovascular LER (151.8%) and open rAAA repair (135.7%). In 2011, patients who had experienced CDI had median LOS of 15 days (interquartile range, 9-25 days) compared with 8.3 days for matched patients without CDI, in-hospital mortality 9.1% (compared with 5.0%), and $13,471 extra cost per hospitalization. The estimated cost associated with CDI in vascular surgery in the United States was ∼$98 million in 2011. Hospital rates of CDI varied from 0 to 50% with 3.5% of hospitals having infection rates ≥5%. Factors associated with CDI included multiple chronic conditions, female gender, surgery type, emergent and weekend hospitalizations, hospital transfers, and urban locations. CONCLUSIONS:Despite potential reduction of infection rates as evidenced by the experience of hospitals with effective interventions, CDI is increasing among vascular surgery patients. It is associated with prolonged LOS, increased mortality, and higher costs.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Egorova NN,Siracuse JJ,McKinsey JF,Nowygrod Rdoi
10.1016/j.avsg.2014.10.031subject
Has Abstractpub_date
2015-01-01 00:00:00pages
792-800issue
4eissn
0890-5096issn
1615-5947pii
S0890-5096(15)00015-1journal_volume
29pub_type
杂志文章abstract::The purpose of this study was to compare the rate of proximal type I endoleaks in patients undergoing endoluminal repair of infrarenal abdominal aortic aneurysms with endografts having either transrenal or infrarenal fixation. From September 1998 to May 2000, 42 patients received endoluminal aortic grafts for the trea...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0276-4
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVES:To analyze the outcome of vascular procedures performed in patients with COVID-19 infection during the 2020 pandemic. METHODS:This is a multicenter, prospective observational cohort study. We analyzed data from 75 patients with COVID-19 infection undergoing vascular surgery procedures in 17 hospitals across...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2021.01.054
更新日期:2021-01-22 00:00:00
abstract:BACKGROUND:Thoracic endovascular aortic repair (TEVAR) is the treatment of choice for thoracic blunt aortic injury (TBAI). A 20 mm proximal seal zone is recommended based on aneurysmal disease literature which often results in coverage of the left subclavian artery (LSA). The aim of this study was to analyze our experi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.12.007
更新日期:2020-12-31 00:00:00
abstract:BACKGROUND:This study aimed to determine the body mass index (BMI) at which duplex ultrasonography does not accurately detect deep vein thrombosis. METHODS:This is a retrospective review of all patients who underwent lower extremity venous duplex examination at a single institution, tertiary vascular laboratory from J...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.03.038
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Calcification is closely related to in situ thrombosis secondary to plaque rupture in the coronary artery. However, the association between calcification in lower extremity arteries and acute thrombosis has not been assessed. We thus sought to determine whether lower limb arterial calcification (LLAC) was co...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.06.043
更新日期:2020-02-01 00:00:00
abstract::We report a case of a compassionate treatment of a ruptured thoracoabdominal aortic aneurysm in a 92-year-old patient. The patient was admitted to our emergency department for acute onset of pain irradiating to the back. Computed tomography angiography showed the presence of a thoracoabdominal aortic aneurysm with a c...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.07.102
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:The aim of the study is to determine whether performing endovascular aortic aneurysm repair (EVAR) in a dedicated vascular hybrid operating room (OR) is associated with a decreased patient radiation and contrast dose compared with mobile C-arm imaging in a conventional OR. METHODS:This is a retrospective st...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.04.019
更新日期:2019-11-01 00:00:00
abstract::Injection drug users frequently present with abscess, cellulitis, and endocarditis. The development of arterial mycotic pseudoaneurysm (AMP) as a sequela of injection drug use, however, is much less frequently reported. We undertook a study to determine the prevalence and presenting clinical characteristics of AMP, ut...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0124-6
更新日期:2002-09-01 00:00:00
abstract::Pseudoaneurysm (PA) formation after carotid endarterectomy (CEA) is a very uncommon but dangerous complication, potentially responsible for cerebral embolism or rupture. Therefore, the PA treatment is imperative. Until few years ago, the treatment of choice was represented by open surgical repair, with a higher mortal...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.051
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Comorbid conditions are known to increase cardiovascular risk in patients with peripheral artery disease (PAD). However, whether comorbid conditions affect walking capacity remains controversial. Previous studies have analyzed comorbidities separately, but they are known to occur in a clustered fashion in PA...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.01.020
更新日期:2014-02-01 00:00:00
abstract::Buerger's disease is frequently diagnosed in young smokers, based on clinical presentation rather than histologic criteria. This report describes a young male with idiopathic aortitis who had been managed for 10 years as Buerger's disease solely on the basis of clinical manifestations. This case emphasizes the need fo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)61447-7
更新日期:1987-12-01 00:00:00
abstract:BACKGROUND:Pregnancy is a hypercoagulable state associated with a fivefold increase in the risk of venous thromboembolism. Thrombolysis is the preferred level of care for patients with acute iliofemoral deep vein thrombosis (DVT); however, most studies exclude pregnant patients, highlighting the lack of data regarding ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.01.018
更新日期:2019-08-01 00:00:00
abstract::The hypoglossal artery is present as an anastomotic channel between the carotid and vertebrobasilar system for approximately one week during embryologic development. Rarely, it may persist into adulthood and may be encountered during cerebrovascular operations. We report a 76-year-old woman with a persistent hypogloss...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(07)60035-1
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:Much has been made of obesity's health impact, largely founded on data regarding patient weight and circulating adipose-derived mediator levels. Paradoxically, a "healthy obese" state exists, but substantial knowledge gaps also exist regarding human adipose-phenotype determinants. Surgical major amputation (...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.07.017
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:The frequency of the occurrence of adverse events associated with carotid artery stenting (CAS) is usually low, but serious adverse events such as cerebral hyperperfusion syndrome (CHS) may occur. Real-time monitoring is ideal for the early detection of adverse events during the surgical procedure. This stud...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.10.034
更新日期:2018-05-01 00:00:00
abstract::The purpose of this study was to estimate the frequency of and review the treatment options for intraoperative endograft access-related vascular complications and early postoperative vascular complications of endovascular repair for aortoiliac aneuryms (EVAR). Between February 1998 and April 2000, 53 patients (46 male...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/s10016-001-0092-x
更新日期:2001-11-01 00:00:00
abstract::Neuropeptide Y (NPY) is a potent vasoconstrictive polypeptide colocalized with norepinephrine in sympathetic neurons. The effects of ischemia and reperfusion on plasma NPY levels were studied and compared in the mongrel dog after infrarenal aortic cross-clamping. We found a two- to threefold increase in NPY levels dur...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02132996
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:This sequential retrospective monocentric study compares the results between general and local anesthesia for carotid endarterectomy (CEA). METHODS:Between November 2002 and October 2004, 428 CEAs were performed in our vascular unit. Two groups were formed: group GA (general anesthesia): 219 patients operat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.04.001
更新日期:2010-11-01 00:00:00
abstract::Secondary to central venous stenosis or thrombosis, alternate sites for permanent hemodialysis need to be explored. The authors' experience with the greater saphenous vein to common femoral artery loop arteriovenous fistula (GSV-CFA AVF) is presented. A retrospective review was performed of 4 women and 3 men with a me...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-004-0016-7
更新日期:2004-03-01 00:00:00
abstract::Primary popliteal venous aneurysm is a rare condition. To date, approximately 150 cases have been reported. In the present article, we report a 59-year-old man who presented with a swelling of the left popliteal fossa. Duplex ultrasound scan revealed a saccular aneurysm of the popliteal vein, with a diameter of 2.5 × ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2011.11.027
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:The treatment for bilateral carotid stenosis (BCS) is challenging, and the optimal treatment strategy is not clear. We report our experience of treating 8 patients with BCS by simultaneous carotid endarterectomy (CEA) and carotid stenting (CAS), thereby providing an alternative for vascular surgeons. METHOD...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.11.017
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Loeys-Dietz syndrome (LDS) is characterized by a triad of aortic aneurysm, vessel tortuosity, and hypertelorism. LDS patients often harbor additional aneurysms and dissections throughout their vasculature. The optimal management of these additional lesions is poorly understood. Accordingly, we sought to anal...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.06.007
更新日期:2017-01-01 00:00:00
abstract::Severe hyperhidrosis is a disabling disorder whose management is controversial. Medical treatment consists of topical aluminum chloride, oral anticholinergics, ionotophoresis, and botulinum toxin A (Botox) injections. Despite the minimally invasive nature of thoracoscopic sympathectomy, there is a common perception th...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2008.04.014
更新日期:2009-01-01 00:00:00
abstract::The great saphenous vein (GSV) is unusable in 20% of cases. The best alternative in these cases is the GSV of the contralateral lower limb (CLL). However, many surgeons are reluctant to harvest the contralateral GSV for fear that it might be needed for future treatment of critical ischemia in the CLL. The purpose of t...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9089-9
更新日期:2006-11-01 00:00:00
abstract::Longitudinal elasticities of whole human blood clot, whole canine blood clot, Factor XIII cross-linked fibrin, glutaraldehyde-fixed human albumin, and formaldehyde-fixed collagen, gelatin and collagen/gelatin were determined and normalized to human whole blood clot. Matrices of a knitted Dacron graft were then impregn...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02042732
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:The best strategy in the treatment for ruptured abdominal aortic aneurysm (RAAA) is an ongoing matter of debate. Differently from several retrospective studies, recent randomized controlled trials (RCTs) failed to demonstrate the superiority of endovascular repair (EVAR) over open repair (OPEN). The aim of t...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.avsg.2014.03.017
更新日期:2014-08-01 00:00:00
abstract::Perforation of inferior vena cava (IVC) by filter struts ranges from 9% to 24%, and clinical sequelae and complications are unpredictable. The aim of this article was to report an unusual case of late complication of IVC filter that caused an IVC wall perforation and penetration of the filter's hooks in the aorta, whi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.11.044
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Early identification of carotid and vertebral artery dissections has been advocated to reduce stroke among trauma patients. We sought to characterize trends in the diagnosis of traumatic carotid and vertebral artery dissections and association changes in stroke rate among Medicare beneficiaries. METHODS:Usi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.06.001
更新日期:2016-10-01 00:00:00
abstract::The association of aortic and common iliac artery aneurysms requires a special strategy to achieve distal seal during the endovascular exclusion of abdominal aortic aneurysms. Coil embolization of the internal iliac artery before the placement of a bifurcated endograft limb into the external iliac artery is a usual op...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2009.08.014
更新日期:2010-04-01 00:00:00
abstract::Stable coil placement is an imperative when treating arterial pathology at branch points. Coil kick and escape threaten distal organs, particularly as the pack tightens. Before the development of the VBX balloon-expandable stent graft (W.L. Gore, Flagstaff, AZ), vessel caliber change often precluded straightforward st...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2020.05.026
更新日期:2020-11-01 00:00:00