Abstract:
OBJECTIVE:This study was conducted to evaluate and compare the rates of postoperative infectious complications and death after elective vascular surgery, define vascular procedures with the greatest risk of developing nosocomial infections, and assess the effect of infection on health care resource utilization. METHODS:The Nationwide Inpatient Sample (2002-2006) was used to identify major vascular procedures by International Classification of Diseases, 9th Clinical Modification (ICD-9-CM) codes. Infectious complications identified included pneumonia, urinary tract infections (UTI), postoperative sepsis, and surgical site infections (SSI). Case-mix-adjusted rates were calculated using a multivariate logistic regression model for infectious complication or death as an outcome and indirect standardization. RESULTS:A total of 870,778 elective vascular surgical procedures were estimated and evaluated with an overall postoperative infection rate of 3.70%. Open abdominal aortic surgery had the greatest rate of postoperative infections, followed by open thoracic procedures and aorta-iliac-femoral bypass. Thoracic endovascular aneurysm repair (TEVAR) infectious complication rates were two times greater than after EVAR (P < .0001). Pneumonia was the most common infectious complication after open aortic surgery (6.63%). UTI was the most common after TEVAR (2.86%) and EVAR (1.31%). Infectious complications were greater in octogenarians (P < .0002), women (P < .0001), and blacks (P < .0001 vs whites and Hispanics). Nosocomial infections after elective vascular surgery significantly increased hospital length of stay (13.8 +/- 15.4 vs 3.5 +/- 4.2 days; P < .001) and reported total hospital cost ($37,834 +/- $42,905 vs $11,851 +/- $11,816; P < .001). CONCLUSIONS:Elective vascular surgical procedures vary widely in the estimated risk of postoperative infection. Open aortic surgery and endarterectomy of the head and neck vessels have, respectively, the greatest and the lowest reported incidence for postoperative infectious complications. Women, octogenarians, and blacks have the highest risk of infectious complications after elective vascular surgery. Disparities in the development of infectious complications on a systems level were also found in larger hospitals and teaching hospitals. Hospital infectious complications were found to significantly increase health care resource utilization. Strategies that reduce nosocomial complications and target high-risk procedures may offer significant future cost savings.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Vogel TR,Dombrovskiy VY,Carson JL,Haser PB,Lowry SF,Graham AMdoi
10.1016/j.jvs.2009.08.006subject
Has Abstractpub_date
2010-01-01 00:00:00pages
122-9; discussion 129-30issue
1eissn
0741-5214issn
1097-6809pii
S0741-5214(09)01619-Xjournal_volume
51pub_type
杂志文章abstract:OBJECTIVE:Quality metrics were developed to improve outcomes after carotid artery revascularization; however, few studies have evaluated regional differences in perioperative outcomes. This study aimed to evaluate regional variation in mortality and perioperative outcomes after carotid endarterectomy (CEA) and carotid ...
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更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Coronavirus disease 2019 (COVID-19) is a novel coronavirus that has typically resulted in upper respiratory symptoms. However, we have encountered acute arterial and venous thrombotic events after COVID-19 infection. Managing acute thrombotic events from the novel virus has presented unprecedented challenges...
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abstract::Late presentation of aortic injuries secondary to internal fixation hardware is uncommon and generally associated with pseudoaneurysm formation. We herein present a case of transmural migration of a pedicle screw into the descending thoracic aorta, which was revealed incidentally by computed tomography scan after almo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.12.084
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:Of 125 surgical patients with abdominal aortic aneurysm (AAA) treated from 1999, 11 patients with deep shock from ruptured AAAs who underwent aortic occlusion balloon catheter (AOBC) insertion before laparotomy were studied. METHODS:With the patients under local anesthesia, the brachial artery was exposed an...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00774-2
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:The simulation and rehearsal of virtual endovascular procedures are anticipated to improve the outcomes of actual procedures. Contemporary, high-fidelity simulation is based on feedback systems that combine concepts of mechanical, electrical, computer, and control systems engineering to reproduce an interact...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.11.074
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:The fenestrated Anaconda endograft (Vascutek/Terumo, Inchinnan, UK) is intended for the treatment of abdominal aortic aneurysms with an insufficient infrarenal landing zone. The endografts are custom-made with use of high-resolution, 1-mm-slice computed tomography angiography images. For every case, a nonster...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.10.108
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:This study was performed for the determination of the expansion rates and outcomes and for recommendations for the surveillance of the 3.0-cm to 3.9-cm abdominal aortic aneurysm (AAA). DESIGN:The study was observational with data from patients screened with ultrasound scanning for AAA at five Veterans Affair...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1067/mva.2002.121572
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:Vein graft adaptation is characterized by loss of expression of the tyrosine kinase receptor Eph-B4, the embryonic determinant of venous identity, without increased expression of its ligand ephrin-B2, the embryonic determinant of arterial identity. Endothelial nitric oxide synthase (eNOS) is an important medi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.11.041
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVES:A protective inferior vena cava (IVC) filter may later be incorporated into a chronic postthrombotic ilio-caval obstruction (occlusive, requiring recanalization, or nonocclusive). This study aims to assess the safety and stent-related outcome following stenting across an obstructed filter. METHODS:From 1997...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.11.117
更新日期:2011-07-01 00:00:00
abstract::Endofibrosis of the external iliac artery is an uncommon disease affecting primarily young, otherwise healthy, endurance athletes. Thigh pain during maximal exercise with quick resolution postexercise is characteristic of the so-called cyclist's iliac syndrome. We report an unusual case in which the typical endofibrot...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2010.02.259
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Haptoglobin (Hp) polymorphism is associated with the prevalence and clinical evolution of many inflammatory diseases and atherosclerosis. Circulating neutrophils and neutrophil-associated proteases are an important initial component of experimental abdominal aortic aneurysm (AAA) formation. Elastase and C-re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.03.016
更新日期:2010-09-01 00:00:00
abstract::Non-uniform terminology in the world's venous literature has continued to pose a significant hindrance to the dissemination of knowledge regarding the management of chronic venous disorders. This VEIN-TERM consensus document was developed by a transatlantic interdisciplinary faculty of experts under the auspices of th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,实务指引
doi:10.1016/j.jvs.2008.09.014
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:There is abundant evidence linking hostile proximal aortic neck anatomy to poor outcome after endovascular aortic aneurysm repair (EVAR), yet the definition of hostile anatomy varies from study to study. This current analysis was undertaken to identify anatomic criteria that are most predictive of success or ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2014.12.063
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to compare blood flow rates measured by Doppler ultrasound (DUS) and phase-contrast magnetic resonance imaging (MRI) in patients having a hemodialysis arteriovenous fistula (AVF) and to identify scenarios in which there was significant discordance between these two approaches. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.02.043
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE AND METHOD:In this retrospective review, we report the surgical results of infected aortic aneurysms treated at a single center over 5 years. RESULTS:From October 1996 to October 2001, 19 patients with infected aortic aneurysm were treated with surgery, nine with suprarenal infections (four proximal descendi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.126557
更新日期:2002-10-01 00:00:00
abstract:PURPOSE:Changes in microvascular permeability play a critical role in the inflammatory sequence of tissue injury leading to leakage of proteins and subsequent edema. Primed responses induced by topical applications of platelet-activating factor (PAF) and histamine greatly increase microvascular permeability and mimic i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70056-0
更新日期:1995-12-01 00:00:00
abstract::Thrombolysis for the treatment of occluded bypass grafts is used in selected clinical circumstances. Unfortunately, a minority of these procedures are technical failures because of the inability to access the occluded graft. We describe a technique that greatly increases the chances of technical success. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70328-9
更新日期:1999-04-01 00:00:00
abstract::One hundred nine percutaneous catheterizations of synthetic vascular grafts in 89 patients who had angiographic procedures were reviewed to determine the risk of major complications. Ninety-six of the catheterizations were inserted into the inguinal portion of aortofemoral grafts. There were no instances of hematoma, ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract:PURPOSE:The early and late outcomes of carotid endarterectomy (CEA) following a rigid protocol of patch angioplasty or occasionally interposition bypass grafting, when the arteriotomy required to obtain a complete internal carotid end point extended distal to the bulb segment, and primary closure, when it was limited t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.104591
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Abdominal aortic aneurysm (AAA) rupture occurs when wall stress exceeds wall strength. Engineering principles suggest that aneurysm diameter is only one aspect of its geometry that influences wall stress. Finite element analysis considers the complete geometry and determines wall stresses throughout the stru...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.09.002
更新日期:2008-01-01 00:00:00
abstract::This review considers the roles of endovascular and open surgery for critical lower limb ischemia. The TransAtlantic Inter-Society Consensus document offers sensible guidelines for the treatment of both suprainguinal and infrainguinal disease. For bilateral/diffuse suprainguinal disease, aortobifemoral bypass remains ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2008.08.036
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Positional stability of the endograft is essential for long-term durability after endovascular abdominal aortic aneurysm repair (EAR). However, the cumulative risk of delayed endograft migration has been sparsely reported. METHOD:A total of 91 patients studied underwent EAR with the AneuRx endograft with a ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.126561
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:Radial-cephalic fistulas (RCFs) perianastomotic stenoses (PASs) are on and around the fistula anastomosis. This group of lesions encompasses juxta-anastomotic stenosis (stenosis located on the venous side within 3 cm away from the anastomosis), anastomotic, and arterial stenosis. The purpose of our study was ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2010.08.007
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:This prospective, observational study evaluated the safety and efficacy of cryopreserved arterial allograft reconstruction in the management of major peripheral arterial graft infections. METHODS:From April 1996 to May 2003, data from patients with major peripheral arterial graft infection who underwent graf...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.09.025
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to analyze our 25-year experience with surgical treatment of visceral artery aneurysms (VAAs), with particular attention paid to early and long-term results. MATERIALS AND METHODS:From January 1982 to September 2007, 55 patients (32 males, 58%, and 23 females, 42%) underwent surgica...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.03.043
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Treatment of chronic venous insufficiency (CVI) has largely focused on reflux. Minimally-invasive techniques to address superficial and perforator reflux have evolved, but correction of deep reflux continues to be challenging. The advent of intravascular ultrasound (IVUS) scan and minimally invasive venous s...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.08.032
更新日期:2010-02-01 00:00:00
abstract:PURPOSE:This retrospective review describes the surgical management of 51 patients after failed percutaneous renal artery angioplasty (F-PTRA). METHODS:From January 1987 through June 1998, 51 consecutive patients underwent surgical repair of either atherosclerotic (32 patients) or fibromuscular dysplastic (FMD; 19 pat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70074-1
更新日期:1999-09-01 00:00:00
abstract:PURPOSE:The efficacy of autogenous infrainguinal reconstruction for patients with varying degrees of chronic renal insufficiency was reviewed because it has not been well defined. METHODS:Pertinent data were retrieved from hospital records and the vascular registry for all patients with chronic renal insufficiency (se...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.42889
更新日期:1993-01-01 00:00:00
abstract::Albeit uncommon, delayed renal dysfunction after endovascular abdominal aortic aneurysm repair (EVAR) can be attributed to proximal stent graft migration or unrecognized partial renal artery coverage. We report two patients who were found to have renal artery occlusion 1 week after EVAR with Zenith (Cook, Bloomington,...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.08.019
更新日期:2008-02-01 00:00:00
abstract::Transcatheter embolization has emerged as the treatment of choice for pelvic arteriovenous malformations (AVMs), because surgical resection may be difficult and is associated with a high recurrence rate. We report a patient with a large recurrent pelvic AVM in whom transcatheter embolization was not feasible. This pat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.02.004
更新日期:2004-06-01 00:00:00