Changes in Referral Practice, Workload, and Operative Mortality After Establishment of an Endovascular Abdominal Aortic Aneurysm Program
| Autor: | Ahktar Nasim, Jonathan R. Boyle, Matt M. Thompson, Patricia Healey, Robert D. Sayers, Peter R.F. Bell |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Retrospective cohort study 030204 cardiovascular system & hematology medicine.disease Endovascular aneurysm repair Abdominal aortic aneurysm 030218 nuclear medicine & medical imaging Surgery 03 medical and health sciences Aortic aneurysm 0302 clinical medicine Aneurysm cardiovascular system medicine Radiology Nuclear Medicine and imaging cardiovascular diseases Elective surgery Cardiology and Cardiovascular Medicine Prospective cohort study business Survival rate |
| Zdroj: | Journal of Endovascular Surgery. 5:201-205 |
| ISSN: | 1074-6218 |
| Popis: | Purpose: To determine the change in referral practice following establishment of an endovascular abdominal aortic aneurysm (AAA) program. Methods: A prospective audit of all elective admissions for AAA was established in January 1994 at the initiation of an endovascular AAA program. A comparison was made between this cohort and the elective AAA repairs performed between 1981 and 1993. Results: Since January 1994, 213 AAA patients (177 men; median age 73 years, range 54 to 88) have been referred for potential endovascular aneurysm repair. To date, 142 patients have undergone elective surgery (41 endovascular and 101 conventional). Between 1981 and 1993, 304 patients (255 men; median age 69 years, range 45 to 86) had elective aneurysm repair. Comparison of the two time periods has revealed significant increases in the number of tertiary referrals (41.8% versus 9.5%, p < 0.01), annual operations (50 versus 23, p < 0.05), and overall mortality (12% versus 6.7%, p < 0.05), the latter attended by a significant increase in cardiorespiratory comorbidity. Conclusions: The higher elective AAA mortality rate since the establishment of an endovascular program reflects a change in referral practice and may be directly attributable to an increase in the number of high-risk patients. An endovascular AAA program has clinical and financial implications for the hospital concerned. |
| Databáze: | OpenAIRE |
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