Single versus multi-specialty operative teams: association with perioperative mortality after endovascular abdominal aortic aneurysm repair.
Am Surg
; 78(2): 207-12, 2012 Feb.
Article
em En
| MEDLINE
| ID: mdl-22369830
ABSTRACT
Endovascular abdominal aortic aneurysm repair (EVAR) requires both endovascular and open surgical skills. Although usually performed by a single operating specialist, EVAR may alternatively involve multiple teams from different specialties performing separate procedural components. We examined the relative frequencies of single versus multi-specialty EVAR in the 2005 to 2008 American College of Surgeons National Surgical Quality Improvement Participant Use Datafile and explored the influence of multi-specialty EVAR on 30-day mortality. EVARs were identified and classified as single or multiple-specialty procedures based on Current Procedural Terminology codes. Baseline and procedural characteristics were compared using χ(2) or Fisher's exact test for categorical variables and t test for continuous variables. The association between multi-specialty EVAR and 30-day mortality was examined using a multivariate logistic regression model. Of 7269 EVAR patients identified, 7086 were single and 183 were multi-specialty. Multi-specialty patients had higher frequency of brachial or iliac artery exposure and longer operative times, but were otherwise similar in baseline and procedural characteristics. In the multivariate model, multi-specialty EVAR was associated with increased risk of 30-day mortality (odds ratio 2.35; 95% confidence interval 1.08-5.11; P value 0.031). Multi-specialty participation in EVAR procedures is associated with significantly higher 30-day mortality. Further research is warranted to determine whether multi-specialty participation reflects provider experience, institutional protocols, procedural complexity, non-surgical or other factors.
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1
Base de dados:
MEDLINE
Assunto principal:
Equipe de Assistência ao Paciente
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Complicações Pós-Operatórias
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Aneurisma da Aorta Abdominal
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Medição de Risco
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Procedimentos Endovasculares
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Melhoria de Qualidade
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article