Search
Print this page
December 23, 2005
Back to Program
James T. McPhee, MD, Maksim Zayaruzny, MD, Mohammad H. Eslami, MD.
University of Massachusetts, Division of Vascular Surgery, Worcester, MA, USA.
Objectives: Endovascular repair of AAA (EVAR) is a viable option for the repair of AAA. Access to EVAR may not be universally available. This study was to determine the sociodemographic factors that influence access to EVAR, and the subsequent impact of this on the surgical outcomes.
Methods: The Nationwide Inpatient Sample (1998-2003) was analyzed to identify patients presenting to urban hospital settings for elective AAA repair. Primary outcome measures of in-hospital mortality and post-operative disposition were analyzed using the chi-square test. A proportional hazards model was used to adjust outcomes for age, gender, race, hospital type, procedure type, income bracket, insurance status and selected co-morbid conditions.
Results: From 1998-2003 an estimated 187,726 patients underwent elective aneurysmorrhaphy. Of that cohort, 42,449 (22%) were treated by EVAR and 145,277 (77%) had open repair (OAR). Overall in-hospital mortality was 3.8 % with a decreasing trend of 4.4%-3.5% from 1998-2003 (p<.0001). The mortality rate for EVAR was lower than OAR (1.1% vs. 3.8% (p<. 0001). Adjusting for covariates, EVAR was performed significantly less often in patients in lower income brackets (<$34,999/year) (OR= 1.56 95% CI 1.33-1.85, p< .0001) and Medicaid recipients (OR 1.28, 95% CI 1.10-1.85, p.05). Teaching vs. non-teaching hospital type also did not significantly affect access to EVAR.
Conclusions: Results suggest that survival rate is higher for EVAR patients. Access to EVAR appears to be preferentially limited to those with better insurance and those in higher income brackets.
Back to Annual Meeting
Back to Program
Does the Race or Socioeconomic Status of Patients with Intact Abdominal Aorta Aneurysm (AAA) Affect Access to Endovascular Technology or Surgical Outcomes?
Back to Annual MeetingBack to Program
James T. McPhee, MD, Maksim Zayaruzny, MD, Mohammad H. Eslami, MD.
University of Massachusetts, Division of Vascular Surgery, Worcester, MA, USA.
Objectives: Endovascular repair of AAA (EVAR) is a viable option for the repair of AAA. Access to EVAR may not be universally available. This study was to determine the sociodemographic factors that influence access to EVAR, and the subsequent impact of this on the surgical outcomes.
Methods: The Nationwide Inpatient Sample (1998-2003) was analyzed to identify patients presenting to urban hospital settings for elective AAA repair. Primary outcome measures of in-hospital mortality and post-operative disposition were analyzed using the chi-square test. A proportional hazards model was used to adjust outcomes for age, gender, race, hospital type, procedure type, income bracket, insurance status and selected co-morbid conditions.
Results: From 1998-2003 an estimated 187,726 patients underwent elective aneurysmorrhaphy. Of that cohort, 42,449 (22%) were treated by EVAR and 145,277 (77%) had open repair (OAR). Overall in-hospital mortality was 3.8 % with a decreasing trend of 4.4%-3.5% from 1998-2003 (p<.0001). The mortality rate for EVAR was lower than OAR (1.1% vs. 3.8% (p<. 0001). Adjusting for covariates, EVAR was performed significantly less often in patients in lower income brackets (<$34,999/year) (OR= 1.56 95% CI 1.33-1.85, p< .0001) and Medicaid recipients (OR 1.28, 95% CI 1.10-1.85, p.05). Teaching vs. non-teaching hospital type also did not significantly affect access to EVAR.
Conclusions: Results suggest that survival rate is higher for EVAR patients. Access to EVAR appears to be preferentially limited to those with better insurance and those in higher income brackets.
Back to Annual Meeting
Back to Program
© 2009 Copyright Society for Clinical Vascular Surgery