Related Experiment Video
Updated: Feb 22, 2026
09:04
Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
9.3K
Hospital readmissions after elective lower extremity vascular procedures
Todd R Vogel1, Jamie B Smith2, Robin L Kruse2
11 Division of Vascular Surgery, University of Missouri, School of Medicine, Columbia, USA.
Vascular
|September 21, 2017
Summary
This study identified risk factors for 30-day readmission after lower extremity revascularization. Factors like heart failure and blood transfusions increased readmission for bypass surgery, while chronic conditions like kidney disease and hypertension impacted endovascular procedures.
Area of Science:
- Vascular Surgery
- Health Services Research
- Epidemiology
Background:
- Peripheral artery disease (PAD) necessitates lower extremity revascularization procedures.
- Understanding 30-day readmission risk factors is crucial for improving patient outcomes and reducing healthcare costs.
- Both open and endovascular approaches are used for lower extremity revascularization, each with distinct risk profiles.
Purpose of the Study:
- To evaluate risk factors associated with 30-day readmission following open and endovascular lower extremity revascularization.
- To identify specific patient characteristics and comorbidities that predict readmission after these procedures.
- To inform clinical practice and develop targeted interventions for high-risk patients.
Main Methods:
- Retrospective analysis of national electronic medical record data (Cerner Health Facts®, 2008-2014).
- Inclusion of patients undergoing open or endovascular lower extremity revascularization for peripheral artery disease.
- Logistic regression models were employed to identify independent predictors of 30-day readmission.
Main Results:
- A total of 2781 open and 2611 endovascular procedures were analyzed.
- The overall 30-day readmission rate was 10.9% (9.6% open vs. 12.3% endovascular, p<.0001).
- Key readmission factors for bypass included blood transfusions, hyponatremia, heart failure, bronchodilator use, black race, and hypokalemia.
- For endovascular procedures, risk factors included vasodilator use, end-stage renal disease, fluid/electrolyte disorders, hypertension, coronary artery disease, and diuretic use.
Conclusions:
- Disease severity is a significant predictor of readmission for both open and endovascular lower extremity revascularization.
- Specific factors like heart failure and transfusions are linked to bypass readmissions, while chronic conditions like CAD and ESRD are associated with endovascular readmissions.
- Identifying these distinct risk factors can guide targeted surveillance and interventions to reduce readmission rates.
Related Concept Videos
01:23Peripheral Artery Disease V: Postoperative Nursing Management
438
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
438
01:27Peripheral Artery Disease III: Interprofessional Care
398
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
398
01:27Pulmonary Embolism III: Nursing Management
491
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
491
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
235
Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
235
01:26Cardiac Catheterization IV: Nursing Management
851
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
851
01:29Venous Thrombosis III: Interprofessional Care
397
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
397