Readmissions after thoracic endovascular aortic repair.

摘要: Abstract Objective The care of patients undergoing thoracic endovascular aortic repair (TEVAR) can be resource intensive, which driven by readmissions. Our objective was to characterize index readmissions at 30, 90, and 180 days after TEVAR. Methods A retrospective analysis the Nationwide Readmissions Database performed for who underwent TEVAR in 2013. Multivariable identified independent predictors readmission 180 days. Results There were 4045 TEVARs descending dissection (37.7%), nonruptured aneurysm (56%), ruptured (6.3%). 419 (11.1%) 30 days, 895 (23.6%) 90 days, 1131 (29.8%) most frequent reason heart related 30 days (15.5%) aorta 90 days (18%) (19.6%). Reinterventions 6.4%, 9.5%, 9.7% 30-, 90-, 180-day readmissions, respectively. majority these included additional stent graft placement (51.9% reinterventions 67.7% 65.9% 180 days). In multivariable analysis, 30-day associated with initial presentation (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.1-3.5; P = .023) diagnosis-related group (DRG) severity grades moderate (OR, 1.42; CI, 0.74-2.73), major 2.47; 1.28-4.74), extreme 1.60; 0.76-3.36; .009). Index independently 1.88; 1.18-3.01; .008), urgent/emergent 1.41; 1.08-1.85; .014), DRG 1.53; 0.95-2.47), 2.27; 1.39-3.7), 2.45; 1.43-4.18; .002). Finally, 180 days, 1.66; 1.05-2.62; .029), 1.37; 1.08-1.79; .013), 1.55; 1.01-2.38), 2.15; 1.38-3.33), 2.39; 1.47-3.89; .002) were, again, readmission. Conclusions large portion treated readmitted commonly heart-related reasons aorta-related 90 treat rupture greater grade an Urgent/emergent These factors are important consider using as a quality measure.