Technique and Short-Term Outcomes for Management of Symptomatic Mycotic Abdominal Aortic Aneurysms With Rifampin-Soaked Endografts

Abstract

Objective: Despite advances in endovascular surgery, lower extremity arterial bypass (LEB) remains the "gold standard" treatment for severe, symptomatic peripheral arterial disease. With recent changes in health care, there has been an increasing emphasis on reducing the hospital length of stay. The purpose of this study was to identify the postoperative complications that occur after discharge from the hospital and to find risk factors for development of such complications.Methods: The 2013 lower extremity revascularization-targeted American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database and generalized 2013 general and vascular surgery NSQIP Participant Use Data File were used for this study. Patient, diagnosis, and procedure characteristics of patients undergoing LEB were assessed. Postoperative complications and their relationship to the median discharge date were identified. Univariate and multivariate analyses were performed to identify the risk factors associated with development of these complications. A prediction model was then created to accurately predict the risk for development of such complications.Results: A total of 2646 patients (65% male, 35% female) were identified in the NSQIP database who underwent LEB during the year 2013. Median length of stay was 6 days. The most common complications after hospital discharge were superficial wound infection (6.2%; days from operation, 16 days), deep wound infection (13.7%; days from operation, 15 days), and wound disruption (1.6%; days from operation, 15 days). Factors associated with deep wound infection included superficial infection (odds ratio [