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Titolo:
Experience in the United States with intact abdominal aortic aneurysm repair
Autore:
Huber, TS; Wang, JG; Derrow, AE; Dame, DA; Ozaki, CK; Zelenock, GB; Flynn, TC; Seeger, JM;
Indirizzi:
Univ Florida, Coll Med, Dept Surg, Gainesville, FL 32611 USA Univ FloridaGainesville FL USA 32611 ept Surg, Gainesville, FL 32611 USA Univ Florida, Coll Med, Dept Hlth Policy & Epidemiol, Gainesville, FL USA Univ Florida Gainesville FL USA Policy & Epidemiol, Gainesville, FL USA William Beaumont Hosp, Dept Surg, Royal Oak, MI 48072 USA William BeaumontHosp Royal Oak MI USA 48072 urg, Royal Oak, MI 48072 USA
Titolo Testata:
JOURNAL OF VASCULAR SURGERY
fascicolo: 2, volume: 33, anno: 2001,
pagine: 304 - 310
SICI:
0741-5214(200102)33:2<304:EITUSW>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
ASYMPTOMATIC CAROTID ATHEROSCLEROSIS; AFFAIRS MEDICAL-CENTERS; VASCULAR-SURGERY; MORTALITY-RATES; OPERATIVE TREATMENT; GENDER DIFFERENCES; COST-EFFECTIVENESS; MANAGEMENT; ENDARTERECTOMY; POPULATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
40
Recensione:
Indirizzi per estratti:
Indirizzo: Huber, TS Univ Florida, Coll Med, Dept Surg, Gainesville, FL 32611 USA Univ Florida Gainesville FL USA 32611 Gainesville, FL 32611 USA
Citazione:
T.S. Huber et al., "Experience in the United States with intact abdominal aortic aneurysm repair", J VASC SURG, 33(2), 2001, pp. 304-310

Abstract

Objectives: The purpose of this study was to determine the current outcomein the United States and to identify predictors of mortality and "bad outcome" after open, intact abdominal aortic aneurysm (AAA) repair. Methods: In a retrospective analysis, data were obtained from the Nationwide Inpatient Sample during 1994-1996. The Nationwide Inpatient Sample is a 20% all-payer stratified sample of nonfederal United States hospitals. Patients older than 49 years were identified by the presence of primary diagnostic (441.4-intact AAA) and procedure (38.44-resection of abdominal aorta with replacement) codes of the International Classification of Diseases, Ninth Revision (ICD-9). In-hospital mortality rate, discharge disposition, bad outcome (death or discharge to an institution), complications (ICD-9 postoperative codes), length of stay, and charges were determined. The mortality rate and bad outcome were analyzed by the use of patient demographics (age,sex, race), patient comorbidities (ICD-9 diagnostic codes), calendar year,and hospital characteristics (size, location, teaching status) with univariate and multivariate analyses. Results: We identified 16,450 intact AAAs repairs during the study years. The mean patient age was 72 +/- 7 (+/- SD) years, and most patients were male (79.7%) and white (94.6%). Most repairs were performed at large (67.3%),urban (92.5%), and nonteaching (66.7%) institutions. The in-hospital mortality rate was 4.2%, the overall complication rate was 32.4%, and 91.2% of patients were discharged home, whereas the bad outcome rate was 12.6%. The median length of stay was 8 days (mean, 10.0 +/- 8.1), and median hospital charges were $28,052 (mean, $35,681 +/- $33,006) in 1996 dollars. Multivariate analysis showed that the mortality rate (P < .05) increased with age (70-79 years, 1.8 odds ratio [OR] [95% CI, 1.4-2.3], > 79 years, 3.8 OR [95% CI, 2.9-4.91), sex (female, 1.6 OR [95% CI, 1.3-1.9]), cerebral vascular occlusive disease (1.8 OR [95% CI, 1.3-2.5]), preoperative renal insufficiency(9.5 OR [95% CI, 7.7-11.7]), and more than three comorbidities (11.2 OR [95% CI, 3.6-35.4]). Multivariate analysis also showed that bad outcome was associated with the same variables in addition to hospital size (small/medium), year of procedure (1996), chronic obstructive pulmonary disease, and two to three comorbidities. Conclusions Outcome after open repair of intact AAA across the United States is quite good. Older, sicker patients may benefit from nonoperative treatment or the potentially lower risk endovascular approaches.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 03:01:16