Factors linked to in-hospital mortality after AAA repair

Editor's Note

In this study, patient factors, hospital case volume, and practice patterns were found to be associated with in-hospital mortality after elective abdominal aortic aneurysm (AAA) repair.

Of 166, 443 AAA repairs performed at 1,207 hospitals, in-hospital mortality was 0.7% for endovascular AAA repair and 3.8% for open AAA repair.

Overall, open repair and intrinsic patient risk were most likely associated with in-hospital mortality, though hospitals with poor general surgery performance and those with at least a 25% proportion of open cases were also significantly associated with mortality.

Based on the findings, appropriate patient selection and medical optimization are the most important means to improve outcomes after AAA repair, but patient referral to high-volume centers of excellence should be a secondary consideration, the researchers say.

Importance Patient- and hospital-level factors affecting outcomes after open and endovascular abdominal aortic aneurysm (AAA) repair are each well described separately, but not together. Objective To describe the association of patient- and hospital-level factors with in-hospital mortality after elective AAA repair. Design, Setting, and Participants Retrospective review of the Nationwide Inpatient Sample database (January 2007-December 2011).