Incidence, Treatment and Mortality in Patients with Abdominal Aortic Aneurysms

Abstract

The hospital incidence of AAA rose from 2005 to 2014, while that of rAAA fell. Endovascular treatment became more common for nrAAA as well as rAAA, and in-hospital mortality fell for both.

Editor's Choice – Hospital Incidence, Treatment, and In Hospital Mortality Following Open and Endovascular Surgery for Thoraco-abdominal Aortic Aneurysms in Germany from 2005 to 2014: Secondary Data Analysis of the Nationwide German DRG Microdata

“…Mortality rates were given as raw values and standardised for sex, age, and medical risk (using the Elixhauser score) applying an indirect standardisation approach. 12,22 Secondary outcomes were prolonged ventilation requirement, blood transfusion (none, 1 e 5 units, > 5 units), transfusion of thrombocytes, acute myocardial infarction, peripheral arterial thrombosis and embolism, mesenteric thrombosis and embolism, renal artery thrombosis and embolism, as well as the necessity of bowel resection or major amputation of lower limbs, and length of hospital stay. Outcomes were analysed according to rupture status (ruptured or non-ruptured) and type of treatment (f/bEVAR, OAR, hybrid).…”

“…General limitations of this study and the methodology applied have been previously described. 12 Missing data…”

Increasing Incidence of Thoracic Aortic Aneurysm Repair in Germany in the Endovascular Era: Secondary Data Analysis of the Nationwide German DRG Microdata

“…Mortality rates were standardised for sex, age, and medical risk (using the Elixhauser score) by applying an indirect standardisation approach. 13 To compare age dependendent outcomes, five age groups were arbitrarily set in order to facilitate comparability with other reports (age < 65 years, 65e69 years, 70e74 years, 75e79 years, and !80 years). A sub-analysis on outcome of octogenarians (patients aged 80e89 years) was performed.…”

Regional frequency variation of revascularization procedures for carotid stenosis in Germany

“…The basic limitations of the data and methods used for this analysis have already been described [17, 27] and are discussed in more detail in the online supplement (eMethods). The most relevant limitations are the following:

The data are not findings made in the clinical setting, but administrative claims data for the purposes of hospital reimbursement.

Since clinical details, e. g., the degree of stenosis or initial neurological symptoms, are not coded in the DRG data, no conclusions can be drawn on the quality of the indications, choice of procedure or guideline conformity.

The StBA’s DRG statistics do not document which diagnoses were already present on admission, making it impossible to reliably differentiate between comorbidity and complication; similarly, it was not possible to measure neurological outcome.

The follow-up period covered only inpatient stays.

All analyses refer to patients’ place of residence; an analysis of the place of treatment on the level of NUTS3 or regional policy region was not possible for data protection reasons.

Exploratory analyses were performed to generate hypotheses and could only be carried out on an aggregated level.

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“…The methods used have already been described in detail elsewhere [16, 17]. The data are stored on StBA servers in accordance with the StBa data protection regulations.…”