Key result
Concurrent aortitis during unruptured abdominal aortic aneurysm repair was associated with higher 30-day mortality than no aortitis (3.2% vs 2.0%; adjusted RR 1.50; 95% CI 1.09-2.07; P=.01).
Why the study?
Aortitis complicates abdominal aortic aneurysm repair but is not currently an exclusion criterion for hospital performance ratings.
Does concurrent aortitis increase 30-day mortality in Medicare beneficiaries undergoing unruptured abdominal aortic aneurysm repair?
Cohort (n=51,508)
Yes
Does concurrent aortitis increase 30-day mortality in Medicare beneficiaries undergoing unruptured abdominal aortic aneurysm repair?
Concurrent aortitis during unruptured AAA repair is associated with a 50% increased risk of 30-day mortality, suggesting these cases should be excluded from routine hospital quality outcome measures.
Answers are grounded in this paper and cite their sources.
Aortitis diagnoses may warrant exclusion from AAA repair quality metrics; observational data leaves open causal inference and need for validation.
Background The US News & World Report' s Best Hospitals Procedures and Conditions ratings aim to assess hospital performance for routine inpatient care. Aortitis is a complicating factor for abdominal aortic aneurysm (AAA) repair, but aortitis diagnoses are not currently an exclusion criteria for the AAA repair rating. We assessed 30-day mortality among patients with aortitis during AAA repair to determine whether aortitis should be an exclusion criterion. Methods We used the Medicare Beneficiary Summary File and Inpatient Limited Data Sets from January 1, 2019, to December 1, 2022. We included all encounters for AAA repair with a diagnosis code for unruptured AAA. We excluded encounters with a diagnosis code for ruptured AAA. We calculated the prevalence of aortitis (defined using International Classification of Diseases , 10th edition, codes) in this population, and used log-linear regression to compare the age- and sex-adjusted risk of 30-day mortality in patients with aortitis vs those without aortitis. We reported the adjusted risk ratio and 95% confidence interval. Results There were 51,508 AAA repair encounters. The prevalence of aortitis was 2.3% (1167/51,508); 30-day mortality occurred in 37/1167 (3.2%) encounters with an aortitis diagnosis vs 998/50,341 (2.0%) without aortitis (adjusted risk ratio, 1.50; 95% confidence interval,1.09-2.07; P = .01). Conclusions AAA repair with concurrent aortitis should be excluded from quality outcome measures.
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Pollock et al. (2024) conducted a cohort in unruptured abdominal aortic aneurysm (AAA) repair (n=51,508). Aortitis vs. No aortitis was evaluated on 30-day mortality (adjusted risk ratio 1.50, 95% CI 1.09-2.07, p=.01). Concurrent aortitis during unruptured abdominal aortic aneurysm repair was associated with higher 30-day mortality than no aortitis (3.2% vs 2.0%; adjusted RR 1.50; 95% CI 1.09-2.07; P=.01).
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