Predicting Postoperative Destination Through Preoperative Evaluation in Elective Open Aortic Aneurysm Repair

Area of Science:

• Vascular Surgery
• Health Services Research

Background:

• Limited data exist for preoperative counseling regarding discharge destination after open abdominal aortic aneurysm repair (OAR).
• Identifying patients at risk for nonhome discharge (NHD) is crucial for resource allocation and patient expectations.

Purpose of the Study:

• To determine preoperative predictors for nonhome discharge (NHD) following elective open abdominal aortic aneurysm repair (OAR).

Main Methods:

• A retrospective analysis of the National Surgical Quality Improvement Program Vascular Procedure Targeted database (2011-2015).
• Inclusion of patients undergoing elective OAR.
• Multivariable logistic regression to identify preoperative factors associated with NHD, defining complex surgery as high operative time.

Main Results:

• Out of 510 patients, 17.1% required NHD.
• Independent predictors for NHD included age ≥70 years, partial dependence, female sex, history of bleeding disorder, and high operative time.
• NHD was not associated with increased major postdischarge complications or unplanned readmissions.

Conclusions:

• Preoperative factors such as age, functional status, sex, bleeding disorder history, and operative complexity can predict NHD after OAR.
• NHD following OAR does not appear to increase the risk of major postdischarge complications or readmissions.
• Understanding these predictors can improve preoperative counseling and patient expectation management.