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Endovascular versus Open Surgical Elective Repair of Infrarenal Abdominal Aortic Aneurysm: Predictors of Patient Discharge Destination¹

¹ From the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Pl, Suite 2H, Boston, MA 02114 (J.L.B., M.T.B., E.F.H., J.S.L., G.S.G.); Department of Epidemiology and Biostatistics, Erasmus University Medical Center, Rotterdam, the Netherlands (J.L.B.); and the Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass (G.S.G.). Received December 13, 2000; revision requested January 26, 2001; revision received March 1; accepted March 23. Address correspondence to J.L.B. (e-mail: johanna@the-data-group.org).

PURPOSE: To evaluate patient discharge destination after elective endovascular or open surgical repair of infrarenal abdominal aortic aneurysm and to determine predictors for discharge to home or to a rehabilitation center.

MATERIALS AND METHODS: All patients electively treated for infrarenal abdominal aortic aneurysm with endovascular repair (n = 182) or open surgery (n = 274) between January 1997 and September 1999 were included. From the hospital database, information on discharge destination, patient characteristics, complications, and length of stay was retrieved. Multiple logistic regression analysis was performed to determine predictors for discharge to home or to a rehabilitation center.

RESULTS: Patient characteristics did not differ significantly between the treatment groups, with the exception of age (mean age, 75.1 vs 72.9 years in the endovascular and open surgical group, respectively; P = .005). Patient discharge destinations differed significantly between the treatment groups (P = .001). After endovascular procedures, 156 (85.7%) of 182 patients went home and 19 (10.4%) of 182 patients went to a rehabilitation center. After open surgery, 187 (68.2%) of 274 patients went home and 64 (23.4%) of 274 patients went to a rehabilitation center. The odds ratio of discharge to a rehabilitation center, instead of home, following endovascular procedures versus open surgery was 0.23 (95% CI: 0.13, 0.43).

CONCLUSION: Following elective repair of infrarenal abdominal aortic aneurysm, significantly more patients went home after an endovascular procedure than after open surgery. Procedure type was a significant predictor of discharge destination.

Index terms: Aneurysm, abdominal, 981.73 • Aneurysm, therapy, 981.1268, 981.1269

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