Increased Length of Hospital Stay after Endovascular Abdominal Aortic Aneurysm Repair: Role of Pulmonary Complications

Objectives The average hospital length of stay plays a significant role in healthcare costs, and is also used as a metric of hospital efficiency. An advantage of endovascular abdominal aortic aneurysm repair (EVAR) is the shorter postoperative time period after the surgery. The purpose of this study...

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Autores principales: Yang, Yang, Lehman, Erik, Aziz, Faisal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6706259/
https://www.ncbi.nlm.nih.gov/pubmed/31467818
http://dx.doi.org/10.7759/cureus.4986
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author Yang, Yang
Lehman, Erik
Aziz, Faisal
author_facet Yang, Yang
Lehman, Erik
Aziz, Faisal
author_sort Yang, Yang
collection PubMed
description Objectives The average hospital length of stay plays a significant role in healthcare costs, and is also used as a metric of hospital efficiency. An advantage of endovascular abdominal aortic aneurysm repair (EVAR) is the shorter postoperative time period after the surgery. The purpose of this study is to review the factors associated with increased length of stay after EVAR. Methods The records from American College of Surgeons National Quality Improvement Program (ACS-NSQIP) database in 2013 were obtained using Procedure Participant User File. Pre-, intra-, and post-operative factors were assessed of patients undergoing EVAR in 2013. Multivariable logistic regression analysis was used to identify independent variables for a hospital length of stay of at least seven days. Results A total of 1,991 patients (18.7% female, 81.3% males) underwent EVAR in 2013. Among these patients, 223 (11.2%) had a hospital stay greater than seven days. Variables significantly associated with length of stay in a multivariable model included: total operation time greater than 180 minutes (vs. less than 90 minutes, OR 1.88, CI 1.03-3.41, p = 0.039), postoperative, and intraoperative transfusions (OR 2.60, CI 1.66-4.08, p < 0.001), return to operating room (OR 2.88, CI 1.55-5.38, p < 0.001), rupture indication for surgery (OR 5.59, CI 3.18-9.83, p < 0.001), myocardial infarction (OR 5.85, CI 2.22-15.43, p < 0.001), preoperative transfusion (OR 13.05, CI 4.26-39.99, p < 0.001), and on ventilator greater than 48 hours (OR 49.65, CI 10.72-230.07, p < 0.001). Conclusions Multiple factors affect length of hospital stay in patients who have undergone EVAR. Patients with postoperative respiratory failure after EVAR have a significantly higher risk for longer hospital stays.
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spelling pubmed-67062592019-08-29 Increased Length of Hospital Stay after Endovascular Abdominal Aortic Aneurysm Repair: Role of Pulmonary Complications Yang, Yang Lehman, Erik Aziz, Faisal Cureus Cardiac/Thoracic/Vascular Surgery Objectives The average hospital length of stay plays a significant role in healthcare costs, and is also used as a metric of hospital efficiency. An advantage of endovascular abdominal aortic aneurysm repair (EVAR) is the shorter postoperative time period after the surgery. The purpose of this study is to review the factors associated with increased length of stay after EVAR. Methods The records from American College of Surgeons National Quality Improvement Program (ACS-NSQIP) database in 2013 were obtained using Procedure Participant User File. Pre-, intra-, and post-operative factors were assessed of patients undergoing EVAR in 2013. Multivariable logistic regression analysis was used to identify independent variables for a hospital length of stay of at least seven days. Results A total of 1,991 patients (18.7% female, 81.3% males) underwent EVAR in 2013. Among these patients, 223 (11.2%) had a hospital stay greater than seven days. Variables significantly associated with length of stay in a multivariable model included: total operation time greater than 180 minutes (vs. less than 90 minutes, OR 1.88, CI 1.03-3.41, p = 0.039), postoperative, and intraoperative transfusions (OR 2.60, CI 1.66-4.08, p < 0.001), return to operating room (OR 2.88, CI 1.55-5.38, p < 0.001), rupture indication for surgery (OR 5.59, CI 3.18-9.83, p < 0.001), myocardial infarction (OR 5.85, CI 2.22-15.43, p < 0.001), preoperative transfusion (OR 13.05, CI 4.26-39.99, p < 0.001), and on ventilator greater than 48 hours (OR 49.65, CI 10.72-230.07, p < 0.001). Conclusions Multiple factors affect length of hospital stay in patients who have undergone EVAR. Patients with postoperative respiratory failure after EVAR have a significantly higher risk for longer hospital stays. Cureus 2019-06-24 /pmc/articles/PMC6706259/ /pubmed/31467818 http://dx.doi.org/10.7759/cureus.4986 Text en Copyright © 2019, Yang et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiac/Thoracic/Vascular Surgery
Yang, Yang
Lehman, Erik
Aziz, Faisal
Increased Length of Hospital Stay after Endovascular Abdominal Aortic Aneurysm Repair: Role of Pulmonary Complications
title Increased Length of Hospital Stay after Endovascular Abdominal Aortic Aneurysm Repair: Role of Pulmonary Complications
title_full Increased Length of Hospital Stay after Endovascular Abdominal Aortic Aneurysm Repair: Role of Pulmonary Complications
title_fullStr Increased Length of Hospital Stay after Endovascular Abdominal Aortic Aneurysm Repair: Role of Pulmonary Complications
title_full_unstemmed Increased Length of Hospital Stay after Endovascular Abdominal Aortic Aneurysm Repair: Role of Pulmonary Complications
title_short Increased Length of Hospital Stay after Endovascular Abdominal Aortic Aneurysm Repair: Role of Pulmonary Complications
title_sort increased length of hospital stay after endovascular abdominal aortic aneurysm repair: role of pulmonary complications
topic Cardiac/Thoracic/Vascular Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6706259/
https://www.ncbi.nlm.nih.gov/pubmed/31467818
http://dx.doi.org/10.7759/cureus.4986
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AT azizfaisal increasedlengthofhospitalstayafterendovascularabdominalaorticaneurysmrepairroleofpulmonarycomplications