Document Detail


Determinants of hospital length of stay after thoracoabdominal aortic aneurysm repair.
MedLine Citation:
PMID:  11932657     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Extended hospital length of stay (LOS) and consequent high costs are associated with thoracic and thoracoabdominal aortic aneurysm (TAAA) surgery. In this study, we examined factors that may influence LOS after TAAA repair.
METHODS: Five hundred forty thoracic and TAAA repairs were performed by one surgeon between 1990 and 1999. The data were analyzed with multiple linear regression with appropriate logarithmic transformation. The predictor variables included patient demographics, disease extent, severity indicators, intraoperative factors, and postoperative complications.
RESULTS: The median LOS was 15 days. Postoperative creatinine level of greater than 2.9 was the most important predictor of LOS, followed by spinal cord deficit, age, and pulmonary complication (all statistically significant with P <.05). A second model constrained to preoperative risk factors showed both age and complete diaphragmatic division to be associated with increased LOS. Preservation of the diaphragm led to reduced LOS by an average of 4 days. The adjunct cerebrospinal fluid drainage and distal aortic perfusion was associated with a decrease in LOS, although it did not reach statistical significance.
CONCLUSION: Renal failure, spinal cord deficit, and pulmonary complication were the major determinants of LOS in patients for TAAA repair. This study shows that the preservation of diaphragmatic function and the use of the adjunct distal aortic perfusion and cerebrospinal fluid drainage may reduce hospital LOS.
Authors:
T T t Huynh; C C Miller; A L Estrera; R Sheinbaum; S J Allen; H J Safi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  35     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-04-04     Completed Date:  2002-05-15     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  648-53     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Memorial Hermann Hospital, University of Texas-Houston, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aortic Aneurysm, Abdominal / epidemiology,  surgery*
Aortic Aneurysm, Thoracic / epidemiology,  surgery*
Diaphragm / physiology
Female
Hospitals, University / utilization*
Humans
Incidence
Length of Stay / statistics & numerical data*
Linear Models
Male
Middle Aged
Postoperative Complications / epidemiology
Renal Insufficiency / epidemiology
Risk Factors
Survival Rate
Texas / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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