Regionalization of Emergent Vascular Surgery for Patients With Ruptured AAA Improves Outcomes

Abstract

Regionalization of r-AAA repair to centers equipped for both r-EVAR and r-OSR decreased mortality by approximately 20%. Transfer did not impact the mortality of r-EVAR at the tertiary center. Care of r-AAA in the US should be centralized to centers equipped with available technology and vascular surgeons.

Association of Interfacility Transfer and Patient and Hospital Characteristics With Thumb Replantation After Traumatic Amputation

“…Centralization of care for complex medical conditions has been identified as an avenue to improve outcomes and reduce costs in various surgical fields. [25][26][27][28] Sakai-Bizmark et al 26 conducted a population-based analysis of pediatric cardiac surgical procedures and found that centralization was associated with reductions in mortality, morbidity, and cost. Moreover, Warner et al 25 conducted a retrospective analysis of patients with ruptured abdominal aortic aneurysm to evaluate the association of centralized care with outcomes and found that the mortality rate was decreased by approximately 20% in association with increased technology and availability of vascular surgeons.…”

Optimal vs Feasible Volume Thresholds in Vascular Surgery

“…However, Warner et al 7 showed that transfer to a major medical center was associated with improved outcomes compared with repair at a lower-volume center. 7 Furthermore, Birkmeyer and Dimick 1 showed that moving patients from low-volume to high-volume centers performing at least 50 repairs per year could save as many as 464 lives annually. While having a lower threshold of 1 case per year may not save as many lives, it would be more politically acceptable and therefore more feasible to implement.…”

Wyniki lecznia operacyjnego pękniętych tętniaków aorty brzusznej (PTAB) w materiale własnym

“…According to data from 1990s, the overall mortality rate in case of a rupture of aortic aneurysm is very high and reaches 80-90%. Subsequent reports demonstrated that it remains high and ranges from 32% to 80%, although according to data from specialized centers from the years 2002-2015, in the United States it varied from 20% to 46%, and between 21.6% and 29.6% in Sweden [1,[3][4][5].…”