Background
Percutaneous endovascular treatment for arterial vascular diseases has revolutionized
vascular care. While these procedures offer improved morbidity, mortality, and length
of stay (LOS), their effect on postdischarge complications is unknown. The objectives
of the study were to evaluate trends in LOS and postdischarge complications over time
and to assess factors associated with postdischarge complications.
Methods
Patients who underwent surgery for common vascular pathologies (abdominal aortic aneurysm,
aortoiliac occlusive disease, lower extremity disease, and carotid stenosis) were
identified from the American College of Surgeons National Surgical Quality Improvement
Program procedure-targeted database (2014–2019). Outcomes included LOS, 30-day complications,
and proportions of postdischarge complications. Predictors of postdischarge complications
were assessed using a multivariable logistic regression.
Results
Of 80,311 patients evaluated, median LOS did not change from 2014 to 2019 (2, interquartile
range 1–5). Overall, 15.7% of patients experienced any 30-day complication, with 31.3%
occurring after discharge. The proportion of postdischarge complications increased
from 29.1% (2014) to 35.9% (2019), P < 0.001. With exception of carotid procedures, endovascular procedures had lower
overall complication rates than open procedures; however, there was an increased proportion
of postdischarge complications for endovascular procedures (all P < 0.001). Factors associated with an increased odds of postdischarge complications
included female, Black or other race, dependent functional status, underweight or
obesity, increased LOS, and procedural time, all P < 0.05.
Conclusions
Across 4 representative common vascular pathologies, endovascular treatments had a
higher proportion of postdischarge complications compared to open procedures. Early
identification and evaluation of postdischarge complications for endovascular patients
may be warranted to avoid unplanned readmission.
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Article Info
Publication History
Published online: July 05, 2022
Accepted:
June 20,
2022
Received:
May 4,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Presentation Information: This study was presented in poster session at 2021 Midwestern Vascular Surgical Society, Chicago, Illinois 9/9–9/11, 2021.
Conflicts of interest: The authors report no conflicts of interest related to the content of this study.
Funding sources: Stipend for Ruojia Debbie Li and Matthew C. Chia is partially supported by National Institutes of Health grant #T32HL094293 .
Disclosure: M.K.E. has received honoraria from Silk Road Medical, Inc. for service on the Roadster Clinical Events Committee and from W.L. Gore & Associates as a TEVAR course director and Data Safety Monitoring Board member.
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