Abstract
In-hospital outcomes associated with abdominal aortic aneurysm (AAA) repair are well described. However, little is known about post-discharge readmission rates, lengths of stay, associated mortality, and costs. We examined 206 consecutive patients who underwent AAA repair at two American hospitals between 1998 and 2000. Index hospitalization and 6-month readmission data were extracted from a resource and cost accounting system used by both hospitals. Among the 206 patients, 183 survived until discharge (mortality rate 11.2%). Among the surviving patients, 38 (21.0%) were readmitted within 6 months. Half of the readmissions occurred within two weeks of discharge, with patients presenting with a diverse array of complications. Nonelective repair and diabetes mellitus were independent predictors of hospital readmission (OR = 2.83, 95% CI = 1.25-6.40, p = 0.01; OR = 6.60, 95% CI = 1.02-42.4, p = 0.047, respectively). For each readmission, the mean length of stay was 10.7 ± 2.5 days and the mean cost was $13,397 ± 3,381. The cumulative number of hospital days during the 6 months post-discharge was 17.7 ± 3.5 days for each readmitted patient and the mean per-patient total cost was $23,262 ± 5,478. The mortality rate among readmitted patients was 13.2%. Overall, readmissions following AAA repair accounted for a cost >50% over and above the cost of the readmitted patients’ index hospitalization. Hospital readmissions are common during the 6 months following AAA repair. Patients who are readmitted experience long lengths of stay and high mortality rates, and their care incurs high costs.
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Acknowledgments
We acknowledge financial support from Pfizer, Inc.; this project was supported by Pfizer Outcomes Research. We also acknowledge Mr. Tong Guo, MSc, for his statistical contributions. We thank Mr. Arik Azoulay, MSc, and Ms. Anya Brox, BSc, for their assistance with the database, Mr. Martin Henkemeyer, Long Beach Memorial Medical Center, Long Beach, California, and Ms. Dana Caulfield, North Shore-Long Island Jewish Health System, Long Island, New York, for their collaboration, and Ms. Flora Teng, BSc, for her help with the manuscript.
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Dr. Eisenberg is a Physician-Scientist of the Quebec Foundation for Health Research. Dr. Pilote is a Physician-Scientist of the Canadian Institutes for Health Research.
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Gioia, L.C., Filion, K.B., Haider, S. et al. Hospital Readmissions Following Abdominal Aortic Aneurysm Repair. Ann Vasc Surg 19, 35–41 (2005). https://doi.org/10.1007/s10016-004-0132-4
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DOI: https://doi.org/10.1007/s10016-004-0132-4