Sean Degmetich1, Megan Brenner1,2,3, Matthew Firek1, Bishoy Zakhary1, Bruno C Coimbra1, Raul Coimbra4,5. 1. Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System Medical Center, 26520 Cactus Ave., CPC Building, Suite 102-5, Moreno Valley, CA, 92555, USA. 2. Department of Surgery, University of California Riverside School of Medicine, Riverside, CA, USA. 3. Department of Surgery, Loma Linda University School of Medicine, Riverside, CA, USA. 4. Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System Medical Center, 26520 Cactus Ave., CPC Building, Suite 102-5, Moreno Valley, CA, 92555, USA. r.coimbra@ruhealth.org. 5. Department of Surgery, Loma Linda University School of Medicine, Riverside, CA, USA. r.coimbra@ruhealth.org.
Abstract
PURPOSE: To compare outcomes between open (OR) and endovascular repair following superficial femoral artery (SFA) injuries. METHODS: This is a cross-sectional study querying the 2012-2014 National Inpatient Sample for SFA injuries. Patients were grouped into OR and stent-graft placement (SGP). Primary outcome was in-hospital mortality. Secondary outcomes included hospital length of stay (HLOS), fasciotomy and amputation rate, and cost. Wilcoxon rank-sum, Kruskal-Wallis, Chi-squared test with Bonferroni adjustment were used as appropriate; p < 0.05 was significant. RESULTS: 255 Patients were identified. Mean age was 34.6 years and majority were males. OR was performed in 82.7%. Overall mortality rate was 3.7%. Median HLOS was 8 days. Fasciotomies were performed in 31% and lower limb amputations in 3.7%. Males more often underwent OR (89.0% vs. 73.1%, p < 0.01). SGP patients were significantly older (44.9 vs. 32.5 years; p < 0.01), and with Medicare insurance (20.5% vs. 6.5%; p < 0.01. Mortality, HLOS, and hospitalization cost were not significantly different. OR patients had higher rate of fasciotomy (35.4% vs. 15.4%; p < 0.01). CONCLUSIONS: Endovascular management is not inferior to OR following SFA injuries and both carry a low amputation rate. OR is associated with a higher fasciotomy rate. Endovascular repair should be considered when technically feasible.
PURPOSE: To compare outcomes between open (OR) and endovascular repair following superficial femoral artery (SFA) injuries. METHODS: This is a cross-sectional study querying the 2012-2014 National Inpatient Sample for SFA injuries. Patients were grouped into OR and stent-graft placement (SGP). Primary outcome was in-hospital mortality. Secondary outcomes included hospital length of stay (HLOS), fasciotomy and amputation rate, and cost. Wilcoxon rank-sum, Kruskal-Wallis, Chi-squared test with Bonferroni adjustment were used as appropriate; p < 0.05 was significant. RESULTS: 255 Patients were identified. Mean age was 34.6 years and majority were males. OR was performed in 82.7%. Overall mortality rate was 3.7%. Median HLOS was 8 days. Fasciotomies were performed in 31% and lower limb amputations in 3.7%. Males more often underwent OR (89.0% vs. 73.1%, p < 0.01). SGP patients were significantly older (44.9 vs. 32.5 years; p < 0.01), and with Medicare insurance (20.5% vs. 6.5%; p < 0.01. Mortality, HLOS, and hospitalization cost were not significantly different. OR patients had higher rate of fasciotomy (35.4% vs. 15.4%; p < 0.01). CONCLUSIONS: Endovascular management is not inferior to OR following SFA injuries and both carry a low amputation rate. OR is associated with a higher fasciotomy rate. Endovascular repair should be considered when technically feasible.
Authors: C Yavuz; S Demirtas; A Caliskan; F Ertas; H Kaya; M Aydin; E D Benli; Y Celik; M N Eren Journal: Eur Rev Med Pharmacol Sci Date: 2013-07 Impact factor: 3.507