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to 3.1% in 2014; P ¼ .64). Postoperative MI was consistently associated with a poorer prognosis with 3.62-fold increased odds of cardiac arrest and a 3.01-to 6.66-fold increased odds of mortality.Comments: The presence of a large number of emergency cases, especially in the open aortic cases and in the later years of the study, adds a bias that makes the conclusion questionable. Little advanced perioperative care can be expected in the rupture abdominal aortic patient or even emergent lower extremity bypass; such patients may not have been connected with the health care system to have progressed to this state without prior intervention. The limitations of the NSQIP database including but not limited to lack of specifics on location of cross-clamping in aortic cases and detailed perioperative medical management prevents adequate drill down for cause and effect. The need for a database such as the Vascular Quality Initiative becomes evident to provide such granularity.

The study shows superior reproducibility of LTL and ITI compared with the OTO method of caliper placement in ultrasound determination of maximum abdominal aortic diameter, and the choice of caliper placement method significantly affects the prevalence of AAAs in screening programs.