Abstract
Purpose: To compare in a population-based analysis the in-hospital mortality and complications following endovascular aneurysm repair (EVAR) vs. open repair in patients transferred for the management of ruptured abdominal aortic aneurysm (RAAA). Methods: Interrogation of the 2003-2007 Nationwide Inpatient Sample database identified 271 patients (205 men; mean age 71.7 years) who were transferred for RAAA treatment. Demographic, patient, and hospital characteristics were analyzed. Hierarchical multivariate logistic regression analyses were employed to identify predictors of in-hospital mortality and complications; results are presented as the odds ratio (OR) and 95% confidence interval (CI). Results: In comparison to open repair (n=207), endovascular repair (n=64) was associated with lower in-hospital mortality (36% vs. <18%, p<0.01) and a lower complication rate (78% vs. 66%, p<0.05). Transferred RAAA patients undergoing EVAR had lower in-hospital mortality (OR 0.21, 95% CI 0.09 to 0.49, p<0.01) and fewer complications (OR 0.49, 95% CI 0.26 to 0.95, p<0.05) than transferred patients having open repair. Conclusion: Compared to open repair, EVAR led to superior short-term clinical outcomes in transferred RAAA patients. In this clinical situation, transfer of stable RAAA patients to institutions capable of performing EVAR is recommended.
Original language | English (US) |
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Pages (from-to) | 88-95 |
Number of pages | 8 |
Journal | Journal of Endovascular Therapy |
Volume | 19 |
Issue number | 1 |
DOIs | |
State | Published - 2012 |
Externally published | Yes |
Keywords
- Complications
- Endovascular aneurysm repair
- Mortality
- Open surgery
- Patient transfer
- Population-based analysis
- Ruptured abdominal aortic aneurysm
- Stent-graft
ASJC Scopus subject areas
- Surgery
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine