Abstract:
BACKGROUND:There is a paucity of data guiding preoperative counseling on the need for discharge to a facility or nonhome discharge (NHD) following elective endovascular repair of abdominal aortic aneurysms (endovascular aneurysm repair [EVAR]). This study seeks to determine the preoperative predictors of NHD following EVAR in baseline home-dwelling patients and to determine whether NHD is associated with major postdischarge complications and readmission. METHODS:This retrospective cohort study utilized the National Surgical Quality Improvement Program Vascular Procedure Targeted database to identify elective EVAR cases admitted from home (2011 to 2015). The primary end point was NHD. A multivariable logistic regression model was used to determine predictive preoperative factors for NHD and to determine whether NHD predicted major postdischarge complications and readmission. RESULTS:Overall 6,276 cases were included; 291 (4.6%) required NHD. NHD were more frequently female, anemic, functionally dependent, nonsmokers, had chronic obstructive pulmonary disease, recent congestive heart failure exacerbation, and open baseline wounds. NHD was associated with complex surgery, indicated by operative time more than the median, 2.5 hr. Significant predictors for NHD on multivariable analysis included female sex (odds ratio [OR]: 2.2, confidence interval [CI]: 1.7-2.9, P < 0.001), octogenarians (OR: 5.7 CI: 2.3-14.1; P < 0.001) and nonagenarians (OR: 14.6, CI: 5.4-39.2; P < 0.001), dependent functional status (OR: 5.4, CI: 3.3-8.8; P < 0.001), preoperative open wound (OR: 3.5, CI: 1.4-8.9; P = 0.006), high operative time (OR: 2.7, CI: 2.0-3.6; P < 0.001), and hypogastric embolization (OR: 1.6, CI: 1.1-2.1 P = 0.022), C-statistic = 0.780. On adjusted analysis, NHD did not independently predict major postdischarge complication (OR: 1.0 CI: 0.6-1.9; P = 0.875) or unplanned readmission (OR 1.0, CI: 0.6-1.5, P = 0.842). CONCLUSIONS:Discharge to skilled facility following EVAR can be predicted using preoperative factors. Future studies should seek to validate these findings in a prospective manner. Identifying high-risk patients' NHD can help define expectations and facilitate early referral to skilled facilities that may reduce hospital length of stay, reducing health-care costs.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Boitano LT,Iannuzzi JC,Tanious A,Mohebali J,Schwartz SI,Chang DC,Clouse WD,Conrad MFdoi
10.1016/j.avsg.2018.12.058subject
Has Abstractpub_date
2019-05-01 00:00:00pages
109-117eissn
0890-5096issn
1615-5947pii
S0890-5096(19)30016-0journal_volume
57pub_type
杂志文章abstract::The aim of this study was to describe the results of resection and graft replacement for type III and IV thoracoabdominal aortic aneurysm repair. In this retrospective study, 27 patients underwent resection and graft replacement for type III (10) or type IV (17) thoracoabdominal aortic aneurysms. Nine patients had rup...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-004-0048-z
更新日期:2004-07-01 00:00:00
abstract::The treatment for obturator bypass graft infection has been rarely reported and is a surgical challenge because it is difficult to debride infected tissue around the graft located in the deep route and to ensure an alternative revascularization route in patients with a history of inguinal infection. Percutaneous conti...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.04.039
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Angiography remains the gold standard imaging modality before infrainguinal bypass. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) have emerged as noninvasive alternatives for preoperative imaging. We sought to examine contemporary trends in the utilization of CTA and MRA as i...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2015.03.039
更新日期:2015-08-01 00:00:00
abstract::Spinal cord ischemic injury is one of the feared complications during aortic cross-clamping. The aim of this study was to investigate whether cyclosporin A (CsA) has a protective effect on spinal cord during ischemia in a rabbit model. A total of 22 New Zealand white rabbits were studied in three groups. One of the gr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9022-2
更新日期:2006-03-01 00:00:00
abstract::The combined presence of an inflammatory abdominal aortic aneurysm and a horseshoe kidney is a rare event with only one reported case in previously published data. We present a case of a horseshoe kidney with a concomitant 6-cm inflammatory abdominal aortic aneurysm and a 3.6-cm right iliac artery aneurysm repaired th...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2010.09.019
更新日期:2011-04-01 00:00:00
abstract::Our aim was to appraise the feasibility and outcomes of subintimal angioplasty (SA) for the percutaneous revascularization of infrainguinal arterial occlusions in patients with critical limb ischemia (CLI). We retrospectively assessed 117 SA procedures in 109 limbs with complete infrainguinal occlusions from 105 patie...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2007.07.018
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Femoropopliteal bypass is a common vascular reconstructive procedure. A significant proportion of bypasses become ineffective within 1 year because of occlusion due to progression of intimal hyperplasia (IH). METHODS:The clinical part of the study involved an analysis of 43 patients with proximal femoropopl...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2009.06.008
更新日期:2009-09-01 00:00:00
abstract::This report describes the surgical management of 24 patients with concurrent abdominal aortic aneurysm (AAA) and urinary tract neoplasm. The patient population consisted of 22 men and two women whose average age was 65.5 years. AAA sizes ranged from 3.1 to 9.0 cm (mean 5.2 cm) in diameter. Urinary tract neoplasms incl...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02143854
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:The natural history of penetrating aortic ulcer (PAU) has been variably described and clear guidelines are lacking. We reviewed our experience with PAUs in a tertiary referral center. METHODS:Imaging reports from January 2010 to December 2017 were retrospectively searched for the diagnosis of "penetrating a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.12.062
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Historically, carotid procedures incur a readmission rate of approximately 6%; however, these studies are not nationally representative and are limited to tracking only the index hospitals. We sought to evaluate a nationally representative database for readmission rates (including different hospitals) after ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.04.025
更新日期:2020-10-01 00:00:00
abstract::We present a case of extra-anatomic axillo-mesenteric reconstruction for chronic mesenteric ischemia. Endovascular access and retrograde bypass options were prohibited by severe aortoiliac occlusive disease. Standard antegrade bypass was impossible because of the presence of a thoracoabdominal aortic aneurysm. This un...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.08.005
更新日期:2016-02-01 00:00:00
abstract::The authors report a case of leiomyosarcoma of the inferior vena cava, responsible for an acute Budd-Chiari syndrome. The diagnosis, suggested by lower limb edema, ascites, and renal failure, was confirmed by sonography, CT scan, and pathological examination. A mesoatrial shunt and right atrial thrombectomy were perfo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/S0890-5096(07)60039-9
更新日期:1989-07-01 00:00:00
abstract::From 1990 to 1992 there was a 43% increase in the number of carotid endarterectomies (CEAs) performed at our institution. Not coincidentally the North American Symptomatic Carotid Endarterectomy Trial study was published in August 1991. To determine whether CEAs could be performed safely at community medical centers, ...
journal_title:Annals of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1007/BF02133062
更新日期:1994-09-01 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::Behçet's disease is a chronic recurrent inflammatory disorder that affects many organs. A 48-year-old man with known Behçet's disease was admitted to the emergency department with aggravating severe back pain and left lower quadrant pain. A contained rupture of infrarenal abdominal aortic aneurysm (AAA) was discovered...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2009.05.011
更新日期:2010-02-01 00:00:00
abstract::We present a case of a high-risk 76-year-old man who was electively admitted for repair of a large infrarenal abdominal aortic aneurysm. After placement of the main body of the bifurcated graft, the contralateral guidewire became entrapped at the level of suprarenal fixation. Multiple endovascular maneuvers were attem...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.11.007
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Case studies and reviews have shown that creatine supplementation can affect kidney function. The objective of this study is to verify the effects of 8 weeks of creatine supplementation on renal function (creatinine clearance: primary outcome) in patients with symptomatic peripheral arterial disease. METHOD...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.avsg.2019.07.008
更新日期:2020-02-01 00:00:00
abstract::Resection of carotid body tumors (neck paragangliomas) carries inherent risks of injury to the cranial nerves and other structures as well excessive blood loss. Preoperative embolization has been used to lessen the morbidity in tumors that are larger than 2 cm in diameter. Two female patients presented for treatment w...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100160010058
更新日期:2001-03-01 00:00:00
abstract::Retracted: "Eversion carotid endarterectomy is associated with impaired postoperative hemodynamic stability compared with the conventional technique" Ann Vasc Surg 2012;26:755e65. This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This a...
journal_title:Annals of vascular surgery
pub_type: 撤回出版物
doi:10.1016/j.avsg.2012.11.002
更新日期:2013-01-01 00:00:00
abstract::The aim of this study was to present a case of iatrogenic thromboembolectomy-related tibialis anterior false aneurysm (FA) treated with endovascular FA exclusion and anterior leg compartment (ALC) operative decompression and to assess the current management options in posttraumatic leg vessel FAs. A 68-year-old man ha...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2012.09.013
更新日期:2013-10-01 00:00:00
abstract::The axillary artery approach has been used for access for complex endovascular aortic procedures such as thoracic endovascular aortic repair with poor anatomy for traditional deployment as well as for fenestrated and branched abdominal aortic endografts. We report the first case of an iliac graft limb deployment throu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.09.014
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to report the 5-year outcome relative to endovascular repair of the common femoral artery (CFA) for occlusive disease. METHODS:Thirty-six consecutive patients (40 limbs) underwent stenting for CFA lesions. Patients were followed up systematically within a prospectively maintain...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.07.088
更新日期:2017-04-01 00:00:00
abstract::Endovascular aneurysm repair has become the first-line treatment modality for infrarenal aortic aneurysms. However, obtaining successful long-term results frequently requires reinterventions. Particularly, delayed type 1a endoleaks pose a challenging problem, as they are often associated with proximal extension of the...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.01.070
更新日期:2018-05-01 00:00:00
abstract::Critical limb ischemia in patients with diabetes at the organ complication stage represents a considerable challenge in vascular medicine. Because of the complexity of the disease and the often symmetric involvement of both lower limbs, a discrepancy between suitable vascular conduit availability and the actual requir...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.02.049
更新日期:2010-10-01 00:00:00
abstract::Aneurysm of the pancreaticoduodenal artery arcade has a well-documented association with occlusion of the celiac axis. The etiology of celiac occlusion is most commonly atherosclerotic disease. Occlusion or severe stenosis of the celiac artery secondary to a median arcuate ligament is less frequently encountered, and ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2013.06.030
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:To evaluate our experience with staged carotid endarterectomy (CEA) followed by coronary artery bypass grafting (CABG) within the perioperative period for patients with severe carotid and coronary artery disease. METHODS:From 1998 to August of 2010, 40 patients who were referred for isolated coronary surger...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.10.002
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Risk factors for early catheter-directed intra-arterial thrombolysis failure in acute lower limb ischemia remain unclear. METHODS:One hundred forty-nine limbs with acute artery or bypass graft thrombosis underwent catheter-directed thrombolysis (maximum of 48 hours). A retrospective data analysis was carrie...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.11.016
更新日期:2014-01-01 00:00:00
abstract::In 163 carotid reconstructions under peridural anesthesia performed from 1988 to 1991, we routinely measured residual systemic and carotid artery pressure during clamping. Seventy-nine patients (48.5%) were asymptomatic and 84 (51.5%) had a history of neurologic manifestations in the form of transient ischemic attacks...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02001887
更新日期:1996-05-01 00:00:00
abstract::Venous thoracic outlet syndrome (V-TOS) and associated subclavian vein thrombosis (SVT) result in significant patient morbidity and can be difficult to manage. Previous studies have suggested that both mechanical compressive factors and pathological alterations in patient coagulation may contribute to the development ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9106-z
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Bypass surgery remains the gold standard for long and complex arterial occlusions in the lower limb. The vein is regarded superior to prosthetic conduits in peripheral arterial bypass surgery. However, this option is often limited because of previous bypass, stripping, or poor quality of the ipsilateral and/...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.06.043
更新日期:2021-01-01 00:00:00