Endovascular repair is associated with superior clinical outcomes in patients transferred for treatment of ruptured abdominal aortic aneurysms

Anant Mandawat, Aditya Mandawat, Julie A. Sosa, Bart E. Muhs, Jeffrey E. Indes

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

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 languageEnglish (US)
Pages (from-to)88-95
Number of pages8
JournalJournal of Endovascular Therapy
Volume19
Issue number1
DOIs
StatePublished - 2012
Externally publishedYes

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

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