Readmissions after acute type B aortic dissection
Readmissions after acute type B aortic dissection
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DOI：
10.1016/j.jvs.2019.08.280
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发表时间：
2020-07-01
影响因子：
4.3
通讯作者：
Secemsky, Eric A.
中科院分区：
文献类型：
--
作者：
Carroll, Brett J.;Schermerhorn, Marc;Secemsky, Eric A.
目的：急性B型主动脉夹层的治疗可采用单纯药物治疗、开腹手术修复或胸椎血管内主动脉修复术（TEVAR）。急性B型主动脉夹层后再入院的全国负担尚未得到全面评估。方法：我们分析了2010年1月1日至2014年12月31日期间因急性B型主动脉夹层住院的成年人，数据来自全国再入院数据库。使用《国际疾病分类》第九版临床修改代码来识别以胸或胸腹主动脉夹层为主要诊断代码的住院患者。主要结局是非选择性的90天再入院。再入院的预测因素采用层次逻辑回归确定。结果：研究人群包括6937例2010年至2014年因B型主动脉夹层意外入院的患者。62.6%的患者仅接受内科治疗，21.0%的患者接受开放性手术修复，16.4%的患者接受TEVAR治疗。非选择性90天再入院率为25.1%（单纯内科治疗23.6%，开放式修复26.9%,TEVAR 28.7%）
Objective: Acute type B aortic dissection can be treated with medical management alone, open surgical repair, or thoracic endovascular aortic repair (TEVAR). The nationwide burden of readmissions after acute type B aortic dissection has not been comprehensively assessed.Methods: We analyzed adults with a hospitalization due to acute type B aortic dissection between January 1, 2010, and December 31, 2014, in the Nationwide Readmissions Database. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify hospitalizations with a primary diagnosis code for thoracic or thoracoabdominal aortic dissection. The primary outcome was nonelective 90-day readmission. Predictors of readmission were determined using hierarchical logistic regression.Results: The study population consisted of 6937 patients with unplanned admissions for type B aortic dissections from 2010 through 2014. Medical management alone was the treatment for 62.6% of patients, 21.0% had open surgical repair, and 16.4% underwent TEVAR. Nonelective 90-day readmission rate was 25.1% (23.6% with medical management alone, 26.9% with open repair, and 28.7% with TEVAR; P