Readmissions after thoracic endovascular aortic repair

Area of Science:

• Vascular Surgery
• Cardiovascular Medicine
• Health Services Research

Background:

• Thoracic endovascular aortic repair (TEVAR) is a critical intervention for aortic diseases.
• Patient care following TEVAR can be resource-intensive, with readmissions contributing significantly to healthcare costs.

Purpose of the Study:

• To characterize the incidence and reasons for index readmissions at 30, 90, and 180 days post-TEVAR.
• To identify independent predictors of these readmissions.

Main Methods:

• Retrospective analysis of the Nationwide Readmissions Database for patients undergoing TEVAR in 2013.
• Multivariable logistic regression was used to identify predictors of readmission at 30, 90, and 180 days.

Main Results:

• Overall index readmission rates were 11.1% at 30 days, 23.6% at 90 days, and 29.8% at 180 days.
• Common readmission reasons included heart-related issues at 30 days and aorta-related issues at 90 and 180 days.
• Initial aortic rupture, higher Diagnosis-Related Group (DRG) severity, and urgent/emergent TEVAR were independently associated with increased readmission risk.

Conclusions:

• A significant proportion of patients experience readmissions after TEVAR, with distinct patterns and causes at different time points.
• Factors such as initial presentation with aortic rupture, higher disease severity, and urgent procedure status are key predictors of readmission.
• These findings are crucial for developing targeted interventions and refining the use of readmissions as a quality metric in TEVAR care.