Show simple item record

dc.contributor.authorSchanzer, Andres
dc.contributor.authorMessina, Louis M.
dc.contributor.authorGhosh, Kaushik
dc.contributor.authorSimons, Jessica P.
dc.contributor.authorRobinson, William P. III
dc.contributor.authorAiello, Francesco A.
dc.contributor.authorGoldberg, Robert J.
dc.contributor.authorRosen, Allison B.
dc.date2022-08-11T08:10:58.000
dc.date.accessioned2022-08-23T17:26:47Z
dc.date.available2022-08-23T17:26:47Z
dc.date.issued2015-01-01
dc.date.submitted2014-12-19
dc.identifier.citation<p>J Vasc Surg. 2015 Jan;61(1):16-22.e1. doi: 10.1016/j.jvs.2014.06.006. Epub 2014 Nov 1. <a href="http://dx.doi.org/10.1016/j.jvs.2014.06.006">Link to article on publisher's site</a></p>
dc.identifier.issn0741-5214 (Linking)
dc.identifier.doi10.1016/j.jvs.2014.06.006
dc.identifier.pmid25441010
dc.identifier.urihttp://hdl.handle.net/20.500.14038/49715
dc.description.abstractOBJECTIVE: Lifelong imaging follow-up is essential to the safe and appropriate management of patients who undergo endovascular abdominal aortic aneurysm repair (EVAR). We sought to evaluate the rate of compliance with imaging follow-up after EVAR and to identify factors associated with being lost to imaging follow-up. METHODS: We identified a 20% sample of continuously enrolled Medicare beneficiaries who underwent EVAR between 2001 and 2008. Using data through 2010 from Medicare Inpatient, Outpatient, and Carrier files, we identified all abdominal imaging studies that may have been performed for EVAR follow-up. Patients were considered lost to annual imaging follow-up if they did not undergo any abdominal imaging study within their last 2 years of follow-up. Multivariable models were constructed to identify independent factors associated with being lost to annual imaging follow-up. RESULTS: Among 19,962 patients who underwent EVAR, the incidence of loss to annual imaging follow-up at 5 years after EVAR was 50%. Primary factors associated with being lost to annual imaging follow-up were advanced age (age 65-69 years, reference; age 75-79 years: hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.15-1.32; age 80-85 years: HR, 1.45; 95% CI, 1.35-1.55; age > 85 years: HR, 2.03; 95% CI, 1.88-2.20) and presentation with an urgent/emergent intact aneurysm (HR, 1.27; 95% CI, 1.20-1.35) or ruptured aneurysm (HR, 1.84; 95% CI, 1.63-2.08). Additional independent factors included several previously diagnosed chronic diseases and South and West regions of the United States. CONCLUSIONS: Annual imaging follow-up compliance after EVAR in the United States is significantly below recommended levels. Quality improvement efforts to encourage improved compliance with imaging follow-up, especially in older patients with multiple comorbidities and in those who underwent EVAR urgently or for rupture, are necessary. rights reserved.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=25441010&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttp://dx.doi.org/10.1016/j.jvs.2014.06.006
dc.subjectUMCCTS funding
dc.subjectCardiovascular Diseases
dc.subjectSurgery
dc.titleFollow-up compliance after endovascular abdominal aortic aneurysm repair in Medicare beneficiaries
dc.typeJournal Article
dc.source.journaltitleJournal of vascular surgery
dc.source.volume61
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/surgery_pp/141
dc.legacy.embargo2015-01-01T00:00:00-08:00
dc.identifier.contextkey6481365
html.description.abstract<p>OBJECTIVE: Lifelong imaging follow-up is essential to the safe and appropriate management of patients who undergo endovascular abdominal aortic aneurysm repair (EVAR). We sought to evaluate the rate of compliance with imaging follow-up after EVAR and to identify factors associated with being lost to imaging follow-up.</p> <p>METHODS: We identified a 20% sample of continuously enrolled Medicare beneficiaries who underwent EVAR between 2001 and 2008. Using data through 2010 from Medicare Inpatient, Outpatient, and Carrier files, we identified all abdominal imaging studies that may have been performed for EVAR follow-up. Patients were considered lost to annual imaging follow-up if they did not undergo any abdominal imaging study within their last 2 years of follow-up. Multivariable models were constructed to identify independent factors associated with being lost to annual imaging follow-up.</p> <p>RESULTS: Among 19,962 patients who underwent EVAR, the incidence of loss to annual imaging follow-up at 5 years after EVAR was 50%. Primary factors associated with being lost to annual imaging follow-up were advanced age (age 65-69 years, reference; age 75-79 years: hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.15-1.32; age 80-85 years: HR, 1.45; 95% CI, 1.35-1.55; age > 85 years: HR, 2.03; 95% CI, 1.88-2.20) and presentation with an urgent/emergent intact aneurysm (HR, 1.27; 95% CI, 1.20-1.35) or ruptured aneurysm (HR, 1.84; 95% CI, 1.63-2.08). Additional independent factors included several previously diagnosed chronic diseases and South and West regions of the United States.</p> <p>CONCLUSIONS: Annual imaging follow-up compliance after EVAR in the United States is significantly below recommended levels. Quality improvement efforts to encourage improved compliance with imaging follow-up, especially in older patients with multiple comorbidities and in those who underwent EVAR urgently or for rupture, are necessary. rights reserved.</p>
dc.identifier.submissionpathsurgery_pp/141
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.contributor.departmentDepartment of Surgery
dc.source.pages16-22.e1


Files in this item

Thumbnail
Name:
Publisher version

This item appears in the following Collection(s)

Show simple item record