Abstract:
OBJECTIVE:Reducing readmissions is an important target for improving patient care and enhancing health care quality and cost-effectiveness. The aim of this study was to assess rates, risk factors, and indications of 30-day readmission after open aortic repair (OAR) and endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysms (AAAs). METHODS:A retrospective analysis of the Premier Healthcare Database from 2009 to 2015 was performed. Indications for readmission after the index procedure, risk factors, and outcomes of the index admission and rehospitalization were evaluated. Multivariate logistic models were used to assess the association between 30-day readmission and different patient and hospital factors. RESULTS:A total of 33,332 AAA repair procedures were identified: 27,483 (82.5%) EVAR and 5849 (17.5%) OAR. The overall rate of 30-day readmission was 8.1%, and it was greater after OAR (12.9% vs 7.1% in EVAR; P < .001). In general, the most common specific readmission diagnoses were infectious complications (16.1%), followed by respiratory and cardiac complications (11.8% and 11.3%, respectively). After multivariate adjustment, OAR was associated with higher 30-day readmission compared with EVAR (adjusted odds ratio, 1.11; 95% confidence interval, 1.0-1.2; P = .04). Other risk factors of 30-day readmission included female gender, emergency and urgent procedures, certain patient comorbidities (dyslipidemia, congestive heart failure, history of transient ischemic attack, previous cardiac surgery, chronic obstructive pulmonary disease, asthma, chronic kidney disease, peripheral vascular disease, and history of malignant disease), and hemorrhage/shock/bleeding occurring during the index admission as well as nonhome discharge. Readmitted patients had an overall in-hospital mortality of 3.6% and paid a median rehospitalization cost of $7757. CONCLUSIONS:Our study shows that around 8.1% of patients undergoing infrarenal AAA repair were readmitted within 30 days. Because many readmissions are unrelated to the index procedure or caused by factors that are nonmodifiable or nonidentifiable at discharge, efforts should focus on discharge planning and improving the decision process regarding discharge destination as well as postdischarge coordination of care for high-risk patients.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Dakour Aridi HN,Locham S,Nejim B,Ghajar NS,Alshaikh H,Malas MBdoi
10.1016/j.jvs.2017.07.106subject
Has Abstractpub_date
2018-03-01 00:00:00pages
747-758.e7issue
3eissn
0741-5214issn
1097-6809pii
S0741-5214(17)31930-4journal_volume
67pub_type
杂志文章abstract:OBJECTIVE:Aortic geometry has been shown to influence the development of endograft malapposition (bird-beaking) in thoracic endovascular aortic repair (TEVAR), but the extent of this relationship lacks clarity. The aim of this study was to develop a reproducible method of measuring bird-beak severity and to investigate...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.11.045
更新日期:2020-10-01 00:00:00
abstract:PURPOSE:The purpose of this study was to investigate the blood flow changes and venous wall movements that occur in the perivalvular area during venous flow, to learn how these physiologic events influence the movements of the valve cusps, and to learn how the movements of the valve cusps influence the venous flow. MA...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00711-0
更新日期:2003-11-01 00:00:00
abstract:PURPOSE:The increasing demand for venous duplex scans despite the relative rarity of detecting acute deep venous thrombosis (DVT) prompted us to review our experience with this diagnostic method. METHODS:We retrospectively analyzed the results and indications of 2993 lower extremity venous duplex scans performed betwe...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(96)70251-3
更新日期:1996-05-01 00:00:00
abstract::Preferred treatment for thromboembolism when heparin fails or is contraindicated is infrarenal inferior vena cava (IVC) interruption. In the present study suprarenal Greenfield filters were placed in 11 patients in whom routine infrarenal IVC interruption would have been inadequate therapy. As identified by IVC venogr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract:PURPOSE:We studied the ability of recombinant adeno-associated virus (rAAV) vectors to achieve gene transfer in vivo to intact rat carotid arteries. METHODS:Isolated segments of uninjured rat carotid arteries were incubated with (1) rAAV vectors that expressed a beta-galactosidase gene, (2) a related vector with no pr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70357-4
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVE:Carotid intervention is safe and effective in stroke prevention in appropriately selected patients. Despite minimal neurologic complications, procedure-related subclinical microemboli are common and their cognitive effects are largely unknown. In this prospective longitudinal study, we sought to determine lon...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.09.057
更新日期:2017-03-01 00:00:00
abstract::Renal cell carcinoma extends into the lumen of the inferior vena cava in approximately 4% of patients at the time of diagnosis. Surgical removal of the intracaval tumor thrombus with radical nephrectomy is the preferred treatment for this malignancy. From January 1977 to June 1990, 31 such patients were examined for c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1991.29912
更新日期:1991-09-01 00:00:00
abstract:PURPOSE:The North American and the European Symptomatic Carotid Endarterectomy Trial investigators reported a conclusive benefit of carotid endarterectomy for patients with symptomatic 70% to 99% internal carotid artery (ICA) stenosis. However, it has been suggested that plaque structure may be an even more important f...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90014-0
更新日期:1994-08-01 00:00:00
abstract::Antithrombin (AT III), a major circulating anticoagulant, may be influenced by ischemia-induced changes in microvascular integrity and contribute to localized hypercoagulability. In a nonheparinized intact canine hindlimb model we determined AT III activity by chromogenic substrate assay (S-2238); coagulation changes ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1989.vs0090740
更新日期:1989-05-01 00:00:00
abstract:PURPOSE:Outcome with selective or systematic stenting with the Palmaz vascular stent was compared in patients with limb-threatening ischemia or persistent disabling claudication despite medical therapy, with less than 7 cm stenosis or occlusion of the superficial femoral artery. METHODS:This was a multicenter prospect...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mva.2003.155
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:Postoperative ischemic colitis (IC) can be a serious complication following infrarenal abdominal aortic aneurysm (AAA) repair. We sought to identify risk factors and outcomes in patients developing IC after open AAA repair and endovascular aneurysm repair (EVAR). METHODS:The American College of Surgeons Nati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.10.064
更新日期:2016-04-01 00:00:00
abstract::The concomitant presence of a thoracic aortic aneurysm and an abdominal aortic aneurysm in patients considered for renal transplantation is extremely rare. To our knowledge, this is the first case report of the successful treatment of multilevel aortic aneurysms together with renal transplantation. The treatment modal...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.02.011
更新日期:2009-07-01 00:00:00
abstract:PURPOSE:This study was performed to examine the role of the vascular endothelium in modulating arterial reactivity to adrenergic vasoconstriction in subcutaneous arteries from patients with type II diabetes. METHODS:Small subcutaneous arteries (inner diameter = 90 to 180 microns) from control subjects (n = 22) and pat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(96)70261-6
更新日期:1996-05-01 00:00:00
abstract::Isolated dissection of the superior mesenteric artery is an uncommon event, but many new cases have been reported recently, reflecting the progress of imaging and suggesting that this pathology is not as rare as previously thought. Here we report a case of superior mesenteric artery dissection where we performed, afte...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.05.048
更新日期:2005-10-01 00:00:00
abstract:PURPOSE:We have purified and partially sequenced a protein from the adventitia of the human aorta (aortic aneurysm antigenic protein 40 kDa; AAAP-40) that has homologies to bovine aortic microfibril-associated glycoprotein (MAGP-36). It is immunoreactive with immunoglobulin G (IgGs) purified from the serum and aortic w...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70194-0
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to analyze the trend in inpatient vascular procedures in the United States over the past decade and predict the future demand for vascular surgeons. METHODS:The Healthcare Cost and Utilization Project Nationwide Inpatient Sample was queried to determine the weighted national est...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.11.061
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:The purpose of our study was to investigate the effect of adipose-derived stem cells (ASCs), endothelial-differentiated ASCs (EC/ASCs), and various conditioned media (CM) on wound healing in a diabetic swine model. We hypothesized that ASC-based therapies would accelerate wound healing. METHODS:Diabetes was ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.01.065
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The decision about the type and location of a hemodialysis vascular access is challenging and can be affected by multiple factors. We explored the effect of several a priori chosen patient characteristics on access outcomes. METHODS:We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2016.01.053
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:To evaluate our initial experience with hypogastric artery occlusion using a nitinol vascular plug during endovascular aortic aneurysm repair (EVAR). METHODS:We reviewed the records and images of 23 consecutive patients who underwent transluminal vessel occlusion of the hypogastric artery with a nitinol plug...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.06.002
更新日期:2008-11-01 00:00:00
abstract:PURPOSE:Although patency data for lower extremity bypass grafts are readily available, few reports have focused on patients' satisfaction after surgical reconstruction for claudication. We reviewed our experience with surgical treatment for claudication, focusing on late outcome from the patients' perspective to furthe...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(96)70146-5
更新日期:1996-07-01 00:00:00
abstract::Endovascular repair is a valid alternative for patients with abdominal aortic aneurysms. However, in patients with concomitant aortocaval fistulas, type II endoleaks may result in a persistent communication between the aneurysm sac and the inferior vena cava. In these patients, prompt closure of the persistent fistula...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.10.138
更新日期:2013-10-01 00:00:00
abstract::Eighteen patients whose mean age was 61 years were referred to us with acute aortic occlusion from 1977 to 1985. Ten patients had cardiac emboli (group I) and eight had aortoiliac occlusive disease (group II). Fourteen of these patients had paresis or paralysis. Diagnosis was prompt but the time lapse from onset of sy...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract:BACKGROUND:Prospective validation of prognostic scoring systems for ruptured abdominal aortic aneurysm (AAA) is lacking. This study assesses the validity of three established risk scores and a new prognostic index. METHOD:Patients admitted with ruptured AAA during a 26-month period (August 2002-December 2004) were rec...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.10.031
更新日期:2008-02-01 00:00:00
abstract::Ascending aortic pseudoaneurysm following prior cardiac or aortic surgery is a rare entity that requires reoperation. Surgical repair is a complex procedure associated with high operative mortality. We report the case of a 76-year-old male patient with an ascending aortic pseudoaneurysm developing from distal anastomo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.08.092
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to summarize the existing literature on the efficacy of carotid endarterectomy in patients with ipsilateral symptomatic carotid stenosis. METHODS:Database searching, relevance assessment, methodologic quality assessments, and data extraction were all performed in duplicate with ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析
doi:10.1016/s0741-5214(99)70100-x
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:Current long-term surveillance after endovascular abdominal aortic aneurysm repair (EVAR) is based on high-resolution contrast-enhanced computed tomography (CT) scans at scheduled, lifelong intervals. The cancer and nephrotoxicity risks of interval CT scanning and prolonged radiation exposure are concerning. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.06.019
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:Surgical treatment of arterial lesions associated with Behçet disease (BD) is often complicated by graft occlusion and recurrence of aneurysms. The purpose of this study was to clarify the long-term outcome of surgical intervention for arterial involvement in BD. METHODS:Ten patients with BD (9 men, 1 woman)...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.03.019
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:The main objective of this study was to define a role of sphingosine-1-phosphate receptor 1 (S1PR1) in the arterial injury response of a human artery. The hypotheses were tested that injury induces an expansion of S1PR1-positive cells and that these cells accumulate toward the lumen because they follow the sp...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.02.053
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:This study evaluated perioperative variables to predict death in nonruptured and ruptured abdominal aortic aneurysm (AAA) surgery. METHODS:A consecutive review of all patients who underwent AAA surgery from January 1984 to December 1993 was carried out. Perioperative variables were analyzed with univariate and...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(96)70077-0
更新日期:1996-10-01 00:00:00
abstract::The literature contains conflicting reports about the potential value of the processed human umbilical vein graft as an arterial substitute. With a view to a better understanding of the ultimate fate of this device, a series of long-term implantation was undertaken with a nonhuman primate model. Dardik Biografts were ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1985.avs0020715
更新日期:1985-09-01 00:00:00