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Readmission after thoracic endovascular aortic repair following blunt thoracic aortic injury

  • Original Article
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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Thoracic endovascular aortic repair (TEVAR) is increasingly utilized to treat blunt thoracic aortic injury (BTAI), but post-discharge outcomes remain underexplored. We examined 90-day readmission in patients treated with TEVAR following BTAI.

Methods

Adult patients discharged alive after TEVAR for BTAI in the Nationwide Readmissions Database between 2016 and 2019 were included. Outcomes examined were 90-day non-elective readmission, primary readmission reasons, and 90-day mortality. As a complementary analysis, 90-day outcomes following TEVAR for BTAI were compared with those following TEVAR for acute type B aortic dissection (TBAD).

Results

We identified 2085 patients who underwent TEVAR for BTAI. The median age was 43 years (IQR, 29–58), 65% of all patients had an ISS ≥ 25, and 13% were readmitted within 90 days. The main primary causes for readmission were sepsis (8.8%), wound complications (6.7%), and neurological complications (6.5%). Two patients developed graft thrombosis as primary readmission reasons. Compared with acute TBAD patients, BTAI patients had a significantly lower rate of readmission within 90 days (BTAI vs. TBAD; 13% vs. 29%; p < .001).

Conclusion

We found a significant proportion of readmission in patients treated with TEVAR for BTAI. However, the 90-day readmission rate after TEVAR for BTAI was significantly lower compared with acute TBAD, and the common cause for readmission was not related to residual aortic disease or vascular devices. This represents an important distinction from other patient populations treated with TEVAR for acute vascular conditions. Elucidating differences between trauma-related TEVAR readmissions and non-traumatic indications better informs both the clinician and patients of expected post-discharge course.

Level of evidence/study type: IV, Therapeutic/care management.

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Data Availability

The datasets generated and analyzed for this study are not publicly available except for those who purchased the data and signed the HCUP Data Use agreement training. Researchers should readily be able to publicly purchase the same databases we did to conduct research.

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Authors and Affiliations

  1. Division of Trauma & Emergency Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., White Building, Suite 506, Boston, MA, 02114, USA

    Anne-Sophie C. Romijn, Jefferson A. Proaño-Zamudio & Emanuele Lagazzi

  2. Division of Trauma & Emergency Surgery, Department of Surgery, Amsterdam University Medical Center, Amsterdam, the Netherlands

    Anne-Sophie C. Romijn & Georgios F. Giannakopoulos

  3. Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Vinamr Rastogi, Sai Divya Yadavalli & Marc L. Schermerhorn

  4. Division of Vascular Surgery, Department of Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands

    Vinamr Rastogi

  5. Division of Acute Care and Trauma Surgery, Department of Surgery, Boston Medical Center, Boston, MA, USA

    Noelle N. Saillant

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  1. Anne-Sophie C. Romijn
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Correspondence to Anne-Sophie C. Romijn.

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The Mass General Brigham Institutional Review Board approved this study, and informed consent was waived.

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The authors declare no competing interests.

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Romijn, AS.C., Proaño-Zamudio, J.A., Rastogi, V. et al. Readmission after thoracic endovascular aortic repair following blunt thoracic aortic injury. Eur J Trauma Emerg Surg 50, 551–559 (2024). https://doi.org/10.1007/s00068-023-02432-4

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  • DOI: https://doi.org/10.1007/s00068-023-02432-4

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