Transcatheter arterial revascularization outcomes at vascular and general surgery teaching hospitals and nonteaching hospitals are comparable

Castigliano Bhamidipati, Damien J. Lapar, George J. Stukenborg, Charles J. Lutz, Margaret C. Tracci, Kenneth J. Cherry, Gilbert R. Upchurch, John A. Kern

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Outcomes following transcatheter interventions at vascular and general surgery teaching hospitals (STH) are unknown. We examine whether surgery training programs influence clinically relevant outcomes after commonly performed endovascular procedures. Methods: Using an all-payer inpatient care database from 2008, we selected adults who underwent either endovascular carotid stenting, endografting of descending thoracic aortic aneurysm, endovascular abdominal aortic aneurysm repair, or peripheral arterial revascularization. Patients were stratified by procedures completed at Surgery Teaching (Participate in Accreditation Council for Graduate Medical Education [ACGME]-accredited vascular and general surgery programs), STH, or nonteaching hospitals (NTH). Hierarchical regression models assessed adverse outcomes and in-hospital mortality among groups. Results: Of the 175,698 records, 44% of the patients were treated at STH, while 56% underwent procedures at NTH. The adjusted odds ratio of any complication or mortality at STH and NTH were similar. Transfers, weekend admissions, and nonelective cases were higher at STH (P <.001, respectively). Paradoxically, STH treated fewer patients with more than three comorbidities compared with NTH (STH: 47% vs NTH: 53%; P <.001). Surgical teaching status did not lower the adjusted odds of mortality for any procedure. Moreover, the occurrence of any complication (adjusted odds ratios, 0.9; 95% confidence interval,.82-1.14; P =.69) and mortality (adjusted odds ratios, 0.9; 95% confidence interval,.74-1.22; P =.67) were equivalent between vascular and general STH. Conclusions: Following commonly performed transcatheter vascular procedures, and despite more transfers, weekend admissions, and nonelective procedures completed at STH, complications, and mortality were comparable across centers.

Original languageEnglish (US)
JournalJournal of vascular surgery
Volume56
Issue number1
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

Fingerprint

Teaching Hospitals
Blood Vessels
Odds Ratio
Hospital Mortality
Mortality
Teaching
Confidence Intervals
Graduate Medical Education
Thoracic Aortic Aneurysm
Endovascular Procedures
Accreditation
Abdominal Aortic Aneurysm
Comorbidity
Inpatients
Databases
Education

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Transcatheter arterial revascularization outcomes at vascular and general surgery teaching hospitals and nonteaching hospitals are comparable. / Bhamidipati, Castigliano; Lapar, Damien J.; Stukenborg, George J.; Lutz, Charles J.; Tracci, Margaret C.; Cherry, Kenneth J.; Upchurch, Gilbert R.; Kern, John A.

In: Journal of vascular surgery, Vol. 56, No. 1, 01.01.2012.

Research output: Contribution to journalArticle

Bhamidipati, Castigliano ; Lapar, Damien J. ; Stukenborg, George J. ; Lutz, Charles J. ; Tracci, Margaret C. ; Cherry, Kenneth J. ; Upchurch, Gilbert R. ; Kern, John A. / Transcatheter arterial revascularization outcomes at vascular and general surgery teaching hospitals and nonteaching hospitals are comparable. In: Journal of vascular surgery. 2012 ; Vol. 56, No. 1.
@article{8b8ce8c662024bbb9d172fd0146b3624,
title = "Transcatheter arterial revascularization outcomes at vascular and general surgery teaching hospitals and nonteaching hospitals are comparable",
abstract = "Background: Outcomes following transcatheter interventions at vascular and general surgery teaching hospitals (STH) are unknown. We examine whether surgery training programs influence clinically relevant outcomes after commonly performed endovascular procedures. Methods: Using an all-payer inpatient care database from 2008, we selected adults who underwent either endovascular carotid stenting, endografting of descending thoracic aortic aneurysm, endovascular abdominal aortic aneurysm repair, or peripheral arterial revascularization. Patients were stratified by procedures completed at Surgery Teaching (Participate in Accreditation Council for Graduate Medical Education [ACGME]-accredited vascular and general surgery programs), STH, or nonteaching hospitals (NTH). Hierarchical regression models assessed adverse outcomes and in-hospital mortality among groups. Results: Of the 175,698 records, 44{\%} of the patients were treated at STH, while 56{\%} underwent procedures at NTH. The adjusted odds ratio of any complication or mortality at STH and NTH were similar. Transfers, weekend admissions, and nonelective cases were higher at STH (P <.001, respectively). Paradoxically, STH treated fewer patients with more than three comorbidities compared with NTH (STH: 47{\%} vs NTH: 53{\%}; P <.001). Surgical teaching status did not lower the adjusted odds of mortality for any procedure. Moreover, the occurrence of any complication (adjusted odds ratios, 0.9; 95{\%} confidence interval,.82-1.14; P =.69) and mortality (adjusted odds ratios, 0.9; 95{\%} confidence interval,.74-1.22; P =.67) were equivalent between vascular and general STH. Conclusions: Following commonly performed transcatheter vascular procedures, and despite more transfers, weekend admissions, and nonelective procedures completed at STH, complications, and mortality were comparable across centers.",
author = "Castigliano Bhamidipati and Lapar, {Damien J.} and Stukenborg, {George J.} and Lutz, {Charles J.} and Tracci, {Margaret C.} and Cherry, {Kenneth J.} and Upchurch, {Gilbert R.} and Kern, {John A.}",
year = "2012",
month = "1",
day = "1",
doi = "10.1016/j.jvs.2011.12.083",
language = "English (US)",
volume = "56",
journal = "Journal of Vascular Surgery",
issn = "0741-5214",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - Transcatheter arterial revascularization outcomes at vascular and general surgery teaching hospitals and nonteaching hospitals are comparable

AU - Bhamidipati, Castigliano

AU - Lapar, Damien J.

AU - Stukenborg, George J.

AU - Lutz, Charles J.

AU - Tracci, Margaret C.

AU - Cherry, Kenneth J.

AU - Upchurch, Gilbert R.

AU - Kern, John A.

PY - 2012/1/1

Y1 - 2012/1/1

N2 - Background: Outcomes following transcatheter interventions at vascular and general surgery teaching hospitals (STH) are unknown. We examine whether surgery training programs influence clinically relevant outcomes after commonly performed endovascular procedures. Methods: Using an all-payer inpatient care database from 2008, we selected adults who underwent either endovascular carotid stenting, endografting of descending thoracic aortic aneurysm, endovascular abdominal aortic aneurysm repair, or peripheral arterial revascularization. Patients were stratified by procedures completed at Surgery Teaching (Participate in Accreditation Council for Graduate Medical Education [ACGME]-accredited vascular and general surgery programs), STH, or nonteaching hospitals (NTH). Hierarchical regression models assessed adverse outcomes and in-hospital mortality among groups. Results: Of the 175,698 records, 44% of the patients were treated at STH, while 56% underwent procedures at NTH. The adjusted odds ratio of any complication or mortality at STH and NTH were similar. Transfers, weekend admissions, and nonelective cases were higher at STH (P <.001, respectively). Paradoxically, STH treated fewer patients with more than three comorbidities compared with NTH (STH: 47% vs NTH: 53%; P <.001). Surgical teaching status did not lower the adjusted odds of mortality for any procedure. Moreover, the occurrence of any complication (adjusted odds ratios, 0.9; 95% confidence interval,.82-1.14; P =.69) and mortality (adjusted odds ratios, 0.9; 95% confidence interval,.74-1.22; P =.67) were equivalent between vascular and general STH. Conclusions: Following commonly performed transcatheter vascular procedures, and despite more transfers, weekend admissions, and nonelective procedures completed at STH, complications, and mortality were comparable across centers.

AB - Background: Outcomes following transcatheter interventions at vascular and general surgery teaching hospitals (STH) are unknown. We examine whether surgery training programs influence clinically relevant outcomes after commonly performed endovascular procedures. Methods: Using an all-payer inpatient care database from 2008, we selected adults who underwent either endovascular carotid stenting, endografting of descending thoracic aortic aneurysm, endovascular abdominal aortic aneurysm repair, or peripheral arterial revascularization. Patients were stratified by procedures completed at Surgery Teaching (Participate in Accreditation Council for Graduate Medical Education [ACGME]-accredited vascular and general surgery programs), STH, or nonteaching hospitals (NTH). Hierarchical regression models assessed adverse outcomes and in-hospital mortality among groups. Results: Of the 175,698 records, 44% of the patients were treated at STH, while 56% underwent procedures at NTH. The adjusted odds ratio of any complication or mortality at STH and NTH were similar. Transfers, weekend admissions, and nonelective cases were higher at STH (P <.001, respectively). Paradoxically, STH treated fewer patients with more than three comorbidities compared with NTH (STH: 47% vs NTH: 53%; P <.001). Surgical teaching status did not lower the adjusted odds of mortality for any procedure. Moreover, the occurrence of any complication (adjusted odds ratios, 0.9; 95% confidence interval,.82-1.14; P =.69) and mortality (adjusted odds ratios, 0.9; 95% confidence interval,.74-1.22; P =.67) were equivalent between vascular and general STH. Conclusions: Following commonly performed transcatheter vascular procedures, and despite more transfers, weekend admissions, and nonelective procedures completed at STH, complications, and mortality were comparable across centers.

UR - http://www.scopus.com/inward/record.url?scp=84862989082&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862989082&partnerID=8YFLogxK

U2 - 10.1016/j.jvs.2011.12.083

DO - 10.1016/j.jvs.2011.12.083

M3 - Article

C2 - 22583853

AN - SCOPUS:84862989082

VL - 56

JO - Journal of Vascular Surgery

JF - Journal of Vascular Surgery

SN - 0741-5214

IS - 1

ER -