Post-discharge Complications and Readmissions after Elective Open Abdominal Aortic Aneurysm Repair
Anand Dayama, MD, Stephen Kolakowski, MD.
San Joaquin General Hospital, French Camp, CA, USA.
Introduction: Open abdominal aortic aneurysm repair is the gold standard treatment for abdominal aortic aneurysm (AAA). In this study, we sought to investigate the incidence of post-discharge complications after elective open AAA Repair and factors associated with readmissions.
Methods: We reviewed the ACS-NSQIP AAA targeted database from 2012 to 2016 to identify patients undergoing elective open AAA repair. The incidence of post-discharge complication was the primary outcome, and hospital readmission was the secondary outcome. The association between readmissions and various patient factors was explored by the use of multivariable logistic regression.
Results: A total of 1853 patients were identified with an overall post-discharge complication rate of 4.4% and the readmission rate of 7% within 30 days of open AAA repair. Of total complication, 39% were wound complication, 18.3% urinary tract infection, 9.8% pneumonia, 7.1% myocardial infarction, 6.1% DVT, and 6.1% pulmonary embolism being the most common. On multivariate analysis, moderate exertion dyspnea (OR 2.1, 95% CI, 1.4-3.2) and visceral revascularization (OR 2.9, 95% CI, 1.5-5.7) was independently associated with 30 days readmissions.
Conclusions: Post-discharge complications after open abdominal aortic aneurysm repair represent a substantial morbidity and hospital readmissions. Implementing standardized strategies to decrease perioperative infection and cardiac optimization may help to decrease the rate of post-discharge complications and associated readmissions. These findings have important implications for patient counseling and informed consent.
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