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Cited by 153Abdominal vascular conditions and treatmentsAortic aneurysm repair treatmentsAortic Disease and Treatment Approaches

The outcome in the United States after thoracoabdominal aortic aneurysm repair, renal artery bypass, and mesenteric revascularization

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Derrow, Amy E., Seeger, James M., Dame, Douglas A., Carter, Randy L., Ozaki, C.Keith, Flynn, Timothy C., Huber, Thomas S.·2001·Journal of Vascular Surgery
DOI 10.1067/mva.2001.115596
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Abstract

Objectives The purpose of this study was to determine outcome and identify predictors of death after thoracoabdominal aortic aneurysm (TAA) repair, renal artery bypass (RAB), and revascularization for chronic mesenteric ischemia (CMI).Patients and methods In this retrospective analysis, data were obtained from the Nationwide Inpatient Sample, a 20% all-payer stratified sample of hospitals in the United States during 1993 to 1997. Patients were identified by the presence of a diagnostic or procedure code from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The main outcomes we examined were death, ICD-9-CM -based complications, length of stay, hospital charges, and disposition. A multivariate model was constructed to predict death.Results A total of 2934 patients were identified (TAA, 540; RAB, 2058; CMI, 336) in the database. The mean age was comparable (TAA, 69 +/- 9 years; RAB, 66 +/- 12 years; CMI, 66 +/- 11 years), but the breakdown between the sexes varied by procedure (male: TAA, 53%; RAB, 55%; CMI, 24%). The mortality rate (TAA, 20.3%; RAB, 7.1%; CMI, 14.7%), complication rate (TAA, 62.2%; RAB, 37.4%; CMI, 44.6%), and the percentage of patients discharged to another institution (TAA, 21.2%; RAB, 9.3%; CMI, 12.0%) were clinically significant for all procedures. The mortality rate for RAB was greater when performed concomitant with an aortic reconstruction (4.4% vs 8.3%). All three procedures were resource intensive as reflected by the median length of stay (TAA, 14 days; RAB, 9 days; CMI, 14 days) and median hospital charges (TAA, $64,493; RAB, $36,830; CMI, $47,390). The multivariate model identified several variables for each procedure that had an impact on the predicted mortality rate (TAA, 14%-76%; RAB, < 1%-46%; CMI, < 2%-87%).Conclusions The operative mortality rates across the United States for patients undergoing TAA repair and RAB are greater than commonly reported in the literature and mandate reexamining the treatment strategies for these complex vascular problems.

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Authors
Derrow, A. E., Seeger, J. M., Dame, D. A., Carter, R. L., Ozaki, C. K., Flynn, T. C., & Huber, T. S.
Affiliations
  • University of Florida Health (US)
  • Malcom Randall VA Medical Center (US)
ORCID
Venue
Journal of Vascular Surgery
Publisher
Elsevier BV
Published
2001-07
Volume
34
Issue
1
Pages
54-61
ISSN
0741-5214 (ISSN-L)
DOI
10.1067/mva.2001.115596
OpenAlex
W2079892305
Cited by
153
References
41
Citations by year
2026: 2 · 2022: 2 · 2021: 1 · 2020: 9 · 2019: 4 · 2018: 2 · 2017: 7 · 2016: 5 · 2015: 4 · 2014: 3 · 2013: 8 · 2012: 17
FWCI
5.94
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Vascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic aneurysm repair treatments
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Disease and Treatment Approaches
Keywords
thoracoabdominal aortic aneurysm repair, renal artery bypass, mesenteric revascularization, chronic mesenteric ischemia, postoperative mortality, postoperative complications, length of hospital stay, hospital charges, predictors of death, aortic reconstruction, hospitalization outcomes, National Inpatient Sample, resource utilization (health care), hospital discharge disposition, United States hospitals
MeSH terms
Aged, Aged, 80 and over, Female, Humans, Length of Stay, Male, Mesenteric Vascular Occlusion, Middle Aged, Retrospective Studies, United States, Survival Analysis, Treatment Outcome, Aortic Aneurysm, Abdominal, Aortic Aneurysm, Thoracic, Hospital Charges

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