Noticias

Noticias

  • Título: Country, Day of the Week, and Hospital Volumes Influence Survival After Ruptured AAA
  • Fecha: 30-09-2014

  • Frank J Criado MD FACS FSVM

    Patient survival after ruptured abdominal aortic aneurysm (rAAA) in the United States outstrips that in English National Health Service hospitals, according to a major new study published in a recent issue of The Lancet. It shows that the odds for surviving are significantly higher in the United States than in England.

    The findings suggest that US patients benefit from more aggressive treatment as American hospitals are more likely (38% more) to offer surgical treatment, resulting in 13% fewer deaths from rAAA compared with English hospitals. “The large mortality difference is concerning,” says author Peter Holt from St George’s Vascular Institute, University of London, United Kingdom. “Our data suggest that failure to deliver proven life-saving surgery is a key reason why in-hospital survival for patients with ruptured abdominal aortic aneurysm is lower in England. In particular, increased use of a less invasive procedure known as endovascular aneurysm repair (EVAR) could save more lives and help to close the mortality gap.”

    Using national administrative data from the Hospital Episode Statistics (HES) for England and the representative Nationwide Inpatient Sample for the USA, the researchers compared survival for 11,799 patients admitted to hospital with rAAA in England and 23,838 patients in the USA between 2005 and 2010.

    The authors found that just 58% of English patients were offered surgery compared with 80% of US patients, and that EVAR was more than twice as common in the United States as in England (21% vs. 9%), resulting in higher in-hospital death rates for English patients (66% vs. 53%). They also found that patients in both countries stood a better chance of undergoing surgery, and therefore survival, if they were treated on a weekday and that patients treated in teaching hospitals with larger bed capacities and seeing a greater number (volume) of rAAA cases each year were less likely to die.



  • Fuente: endovascular.es