A prospective study of discharge disposition after vascular surgery

D. Scott Crouch, Robert Mclafferty, Laura A. Karch, Mark A. Mattos, Don E. Ramsey, John P. Henretta, Kim J. Hodgson, David S. Sumner

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: The purpose of this study was to determine what factors are predictive of a decline in independent living after vascular surgery during recovery. Methods: Demographics, risk factors, operations, complications, wound status, and discharge disposition for all patients admitted to a tertiary vascular surgery service for any surgical procedure were prospectively recorded at the time of discharge. The declining order of dispositions at discharge were home (no professional assistance), home (professional assistance), rehabilitation facility, and skilled nursing facility. Results: Over a 15-month period, 380 patients underwent 442 primary operations. Primary operations included 74 (17%) carotid procedures, 38 (8%) aortic procedures, 186 (42%) extremity revascularizations, 29 (7%) major amputations, 45 (10%) minor amputations, and 70 (16%) other. There were 148 (33%) complications and 85 (20%) subsequent operations (same hospitalization); 159 (36%) open wounds occurred. Forty-six percent of the patients were discharged to home (no professional assistance), 28% to home (professional assistance), 3% to a rehabilitation facility, and 18% to a skilled nursing facility; 5% died. At discharge, 51% of patients required professional assistance, 39% had a decline in disposition, and 12% went from home (± professional assistance) to a facility. By multivariate regression analysis, a hospital stay more than 6 days, emergency operation, open operative wound, systemic complications, and minor amputation were significantly associated (P <.001) with a decline in disposition at discharge (odds ratios: 5.5, 3.7, 3.6, 3.6, and 2.8, respectively). Conclusions: Prospective study reveals that a large proportion of patients (39%) had a decline in disposition after vascular surgery. A hospital stay more than 6 days, emergency operation, open operative wound, systemic complications, and minor amputation were strong independent predictors of decline. This information suggests modifications in treatment strategies may improve independent living status after vascular surgery and decrease the intense use of extended care resources required for this patient population during recovery.

Original languageEnglish (US)
Pages (from-to)62-68
Number of pages7
JournalJournal of Vascular Surgery
Volume34
Issue number1
DOIs
StatePublished - Jul 2001
Externally publishedYes

Fingerprint

Blood Vessels
Prospective Studies
Amputation
Skilled Nursing Facilities
Independent Living
Wounds and Injuries
Length of Stay
Emergencies
Rehabilitation
Hospitalization
Multivariate Analysis
Extremities
Odds Ratio
Regression Analysis
Demography
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Crouch, D. S., Mclafferty, R., Karch, L. A., Mattos, M. A., Ramsey, D. E., Henretta, J. P., ... Sumner, D. S. (2001). A prospective study of discharge disposition after vascular surgery. Journal of Vascular Surgery, 34(1), 62-68. https://doi.org/10.1067/mva.2001.115597

A prospective study of discharge disposition after vascular surgery. / Crouch, D. Scott; Mclafferty, Robert; Karch, Laura A.; Mattos, Mark A.; Ramsey, Don E.; Henretta, John P.; Hodgson, Kim J.; Sumner, David S.

In: Journal of Vascular Surgery, Vol. 34, No. 1, 07.2001, p. 62-68.

Research output: Contribution to journalArticle

Crouch, DS, Mclafferty, R, Karch, LA, Mattos, MA, Ramsey, DE, Henretta, JP, Hodgson, KJ & Sumner, DS 2001, 'A prospective study of discharge disposition after vascular surgery', Journal of Vascular Surgery, vol. 34, no. 1, pp. 62-68. https://doi.org/10.1067/mva.2001.115597
Crouch, D. Scott ; Mclafferty, Robert ; Karch, Laura A. ; Mattos, Mark A. ; Ramsey, Don E. ; Henretta, John P. ; Hodgson, Kim J. ; Sumner, David S. / A prospective study of discharge disposition after vascular surgery. In: Journal of Vascular Surgery. 2001 ; Vol. 34, No. 1. pp. 62-68.
@article{ba277e0636894c32a7825c0a1614550c,
title = "A prospective study of discharge disposition after vascular surgery",
abstract = "Objective: The purpose of this study was to determine what factors are predictive of a decline in independent living after vascular surgery during recovery. Methods: Demographics, risk factors, operations, complications, wound status, and discharge disposition for all patients admitted to a tertiary vascular surgery service for any surgical procedure were prospectively recorded at the time of discharge. The declining order of dispositions at discharge were home (no professional assistance), home (professional assistance), rehabilitation facility, and skilled nursing facility. Results: Over a 15-month period, 380 patients underwent 442 primary operations. Primary operations included 74 (17{\%}) carotid procedures, 38 (8{\%}) aortic procedures, 186 (42{\%}) extremity revascularizations, 29 (7{\%}) major amputations, 45 (10{\%}) minor amputations, and 70 (16{\%}) other. There were 148 (33{\%}) complications and 85 (20{\%}) subsequent operations (same hospitalization); 159 (36{\%}) open wounds occurred. Forty-six percent of the patients were discharged to home (no professional assistance), 28{\%} to home (professional assistance), 3{\%} to a rehabilitation facility, and 18{\%} to a skilled nursing facility; 5{\%} died. At discharge, 51{\%} of patients required professional assistance, 39{\%} had a decline in disposition, and 12{\%} went from home (± professional assistance) to a facility. By multivariate regression analysis, a hospital stay more than 6 days, emergency operation, open operative wound, systemic complications, and minor amputation were significantly associated (P <.001) with a decline in disposition at discharge (odds ratios: 5.5, 3.7, 3.6, 3.6, and 2.8, respectively). Conclusions: Prospective study reveals that a large proportion of patients (39{\%}) had a decline in disposition after vascular surgery. A hospital stay more than 6 days, emergency operation, open operative wound, systemic complications, and minor amputation were strong independent predictors of decline. This information suggests modifications in treatment strategies may improve independent living status after vascular surgery and decrease the intense use of extended care resources required for this patient population during recovery.",
author = "Crouch, {D. Scott} and Robert Mclafferty and Karch, {Laura A.} and Mattos, {Mark A.} and Ramsey, {Don E.} and Henretta, {John P.} and Hodgson, {Kim J.} and Sumner, {David S.}",
year = "2001",
month = "7",
doi = "10.1067/mva.2001.115597",
language = "English (US)",
volume = "34",
pages = "62--68",
journal = "Journal of Vascular Surgery",
issn = "0741-5214",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - A prospective study of discharge disposition after vascular surgery

AU - Crouch, D. Scott

AU - Mclafferty, Robert

AU - Karch, Laura A.

AU - Mattos, Mark A.

AU - Ramsey, Don E.

AU - Henretta, John P.

AU - Hodgson, Kim J.

AU - Sumner, David S.

PY - 2001/7

Y1 - 2001/7

N2 - Objective: The purpose of this study was to determine what factors are predictive of a decline in independent living after vascular surgery during recovery. Methods: Demographics, risk factors, operations, complications, wound status, and discharge disposition for all patients admitted to a tertiary vascular surgery service for any surgical procedure were prospectively recorded at the time of discharge. The declining order of dispositions at discharge were home (no professional assistance), home (professional assistance), rehabilitation facility, and skilled nursing facility. Results: Over a 15-month period, 380 patients underwent 442 primary operations. Primary operations included 74 (17%) carotid procedures, 38 (8%) aortic procedures, 186 (42%) extremity revascularizations, 29 (7%) major amputations, 45 (10%) minor amputations, and 70 (16%) other. There were 148 (33%) complications and 85 (20%) subsequent operations (same hospitalization); 159 (36%) open wounds occurred. Forty-six percent of the patients were discharged to home (no professional assistance), 28% to home (professional assistance), 3% to a rehabilitation facility, and 18% to a skilled nursing facility; 5% died. At discharge, 51% of patients required professional assistance, 39% had a decline in disposition, and 12% went from home (± professional assistance) to a facility. By multivariate regression analysis, a hospital stay more than 6 days, emergency operation, open operative wound, systemic complications, and minor amputation were significantly associated (P <.001) with a decline in disposition at discharge (odds ratios: 5.5, 3.7, 3.6, 3.6, and 2.8, respectively). Conclusions: Prospective study reveals that a large proportion of patients (39%) had a decline in disposition after vascular surgery. A hospital stay more than 6 days, emergency operation, open operative wound, systemic complications, and minor amputation were strong independent predictors of decline. This information suggests modifications in treatment strategies may improve independent living status after vascular surgery and decrease the intense use of extended care resources required for this patient population during recovery.

AB - Objective: The purpose of this study was to determine what factors are predictive of a decline in independent living after vascular surgery during recovery. Methods: Demographics, risk factors, operations, complications, wound status, and discharge disposition for all patients admitted to a tertiary vascular surgery service for any surgical procedure were prospectively recorded at the time of discharge. The declining order of dispositions at discharge were home (no professional assistance), home (professional assistance), rehabilitation facility, and skilled nursing facility. Results: Over a 15-month period, 380 patients underwent 442 primary operations. Primary operations included 74 (17%) carotid procedures, 38 (8%) aortic procedures, 186 (42%) extremity revascularizations, 29 (7%) major amputations, 45 (10%) minor amputations, and 70 (16%) other. There were 148 (33%) complications and 85 (20%) subsequent operations (same hospitalization); 159 (36%) open wounds occurred. Forty-six percent of the patients were discharged to home (no professional assistance), 28% to home (professional assistance), 3% to a rehabilitation facility, and 18% to a skilled nursing facility; 5% died. At discharge, 51% of patients required professional assistance, 39% had a decline in disposition, and 12% went from home (± professional assistance) to a facility. By multivariate regression analysis, a hospital stay more than 6 days, emergency operation, open operative wound, systemic complications, and minor amputation were significantly associated (P <.001) with a decline in disposition at discharge (odds ratios: 5.5, 3.7, 3.6, 3.6, and 2.8, respectively). Conclusions: Prospective study reveals that a large proportion of patients (39%) had a decline in disposition after vascular surgery. A hospital stay more than 6 days, emergency operation, open operative wound, systemic complications, and minor amputation were strong independent predictors of decline. This information suggests modifications in treatment strategies may improve independent living status after vascular surgery and decrease the intense use of extended care resources required for this patient population during recovery.

UR - http://www.scopus.com/inward/record.url?scp=0035403255&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035403255&partnerID=8YFLogxK

U2 - 10.1067/mva.2001.115597

DO - 10.1067/mva.2001.115597

M3 - Article

C2 - 11436076

AN - SCOPUS:0035403255

VL - 34

SP - 62

EP - 68

JO - Journal of Vascular Surgery

JF - Journal of Vascular Surgery

SN - 0741-5214

IS - 1

ER -