title: Nationwide trends in abdominal aortic aneurysm repair and use of endovascular repair in the emergency setting.
abstract: OBJECTIVE
  To analyze nationwide trends in abdominal aortic aneurysm (AAA) repair and the use of endovascular abdominal aortic aneurysm repair (EVAR) in the emergency setting.
  
  
  METHODS
  Data were obtained from the Nationwide Inpatient Sample (NIS) using the International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9-CM) codes for open and endovascular repairs from 2001-2009. Trends in outcome parameters and hospital charges were compared.
  
  
  RESULTS
  The number of emergency EVAR procedures increased from 382 in 2001 to 1,247 in 2009 (P < .001). During the study period, length of hospital stay associated with total number of EVAR procedures decreased from 3.8 days to 3.4 days (P < .05), and the in-hospital mortality decreased from 2.4% to 2% (P = .32). From 2001-2009, mean hospital charges associated with EVAR increased from $50,630 to $91,401 (74% increase), whereas charges associated with open repairs increased from $54,578 to $128,925 (136% increase). The proportion of patients needing rehabilitation or nursing home placement after EVAR increased from 5.8% to 7.7% (P < .01), and need for home health increased from 6.9% to 10.5% (P < .01).
  
  
  CONCLUSIONS
  There was a significant increase in the number of emergency EVAR procedures during the study period; however, the overall in-hospital mortality associated with EVAR remained unchanged, and the length of hospital stay showed a decreasing trend. The total hospital charges for EVAR were lower than the charges for open abdominal aneurysm repair throughout the study period; the difference in charges between the procedures showed a significant increasing trend with time.
authors.affiliation: Department of Diagnostic and Interventional Radiology, St Francis Hospital, Evanston, IL 60202, USA. prasoonpm@gmail.com
authors.forename: Prasoon P
authors.initials: PP
authors.lastname: Mohan
authors.forename: Michael
authors.initials: M
authors.lastname: Rozenfeld
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kane
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Calandra
authors.forename: Michael H
authors.initials: MH
authors.lastname: Hamblin
mesh_terms: D000704:Analysis of Variance; D017544:Aortic Aneurysm, Abdominal / Q000191:economics / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000191:economics / Q000401:mortality / Q000639:trends*; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000191:economics / Q000639:trends*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000191:economics / Q000401:mortality / Q000639:trends*; D006699:Home Care Services / Q000639:trends; D017721:Hospital Costs; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000639:trends; D016014:Linear Models; D009735:Nursing Homes / Q000639:trends; D010351:Patient Discharge / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012047:Rehabilitation Centers / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States