Determinants of Follow-Up Failure in Patients Undergoing Vascular Surgery Procedures

Five-year reintervention after endovascular abdominal aortic aneurysm repair in the Vascular Quality Initiative

“…Although the Society for Vascular Surgery and the United States Food and Drug Administration have recommended annual imaging surveillance after EVR, approximately 50% of Medicare EVR patients are lost to imaging follow-up. 6,[15][16][17][18] This surveillance failure has been associated with inferior clinical outcomes, highlighting the need for improvement in patient surveillance mechanisms, which could include patient education as to the implications of loss to follow-up, and collaborative efforts with primary care physicians and patient care networks, among others. 19 Conversely, the rate of late aneurysm rupture was much lower, at 3% over 5 years.…”

Loss to follow-up 1 year after lower extremity peripheral vascular intervention is associated with worse survival

“…Indeed, Judelson et al found that center-specific attributes were highly influential in impacting LTF status. 6 The modality of follow-up ultimately was influential on the long-term survival of these patients, with face-to-face follow-up rendering a more protective effect against mortality compared to phone follow-up. Face-to-face follow-up was similarly found to be protective against mortality in a study evaluating the impact of follow-up on EVAR patients.…”

“…Participation in the VQI mandates that 1-year follow-up (between 9 and 15 months) is performed and recorded in a follow-up form, in accordance with previous studies. 6 For ease of analysis, only the first chronologically occurring PVI was included as the index procedure for the patient. Owing to possible issues of survivorship bias, those patients who died before 9 months from the procedure were excluded from the denominator, as they were considered ineligible for follow-up.…”

A comparison of reintervention rates after endovascular aneurysm repair between the Vascular Quality Initiative registry, Medicare claims, and chart review

“…Current reports suggest nearly one in three patients undergoing EVAR is lost to follow up within the first three years. 6–9 Combining data from vascular registries, such as the Vascular Quality Initiative (VQI), 10 with Medicare claims 11 may offer a solution to this challenging problem. The VQI registry was created to allow surgeons to follow procedure specific outcomes and provide clinically relevant information to patients and physicians regarding their vascular care.…”

“…However, the VQI registry is only designed to capture one-year outcomes – not long enough to provide adequate surveillance after EVAR – and follow up continues to be challenging for many surgical practices. 9 Conversely, Medicare claims data offers the advantage of long-term follow up for a large number of patients, and can identify procedures performed at different institutions. However, it can be difficult to accurately identify patients and clinical events using the diagnostic and procedural codes implemented for billing.…”