title: [Perioperative mortality following repair for abdominal aortic aneurysm in Germany : Comparison of administrative data of the DAK health insurance and clinical registry data of the German Vascular Society].
abstract: OBJECTIVE
  This study determined whether the routine data of a single health insurance company (DAK health) can allow equivalent statements on hospital mortality of endovascular (EVAR) and open (OR) repair of intact (iAAA) and ruptured (rAAA) aortic aneurysms (AAA) in Germany in comparison to clinical registry surveys of the German Vascular Society (GVS).
  
  
  METHODS
  The study compared two cohorts that were comparable in group sizes but not identical in terms of the duration of treatment and the selection of the centers. The GVS registry included 5080 patients with iAAA and 485 with rAAA and the DAK data consisted of 5182 patients with iAAA and 576 with rAAA. In GVS (in brackets DAK) 72.6 % (71.0 %) of patients with iAAA received EVAR and 27.4 % (29 %) OR, with rAAA 34.6 % (26.9 %) of patients received EVAR and 65.4 % (73.1 %) OR. Both cohorts were comparable with respect to patient age and gender distribution.
  
  
  RESULTS
  Intact AAA: the hospital mortality rate in GVS (DAK in brackets) was 0.95 % (1.4 %) with EVAR and 4.7 % (5.5 %) with OR. For patients less than 80 years old the statements were almost identical when the hospital mortality in the GVS and DAK registers constituted 0.85 % and 0.9 % after EVAR and 3.8 % and 4.0 % after OR, respectively. Patients over 80 years old in particular had a benefit by EVAR as the hospital mortality in GVS (DAK in brackets) was 1.3 % (2.6 %) with EVAR vs. 13.9 % (17.4 %) with OR. A benefit by EVAR was also seen in women. Ruptured AAA: the hospital mortality rate in GVS (DAK in brackets) was 19.6 % (27.1 %) with EVAR and 38.5 % (42.0 %) with OR. Again, particularly patients over 80 years old showed an advantage with EVAR where the hospital mortality was 31.0 % (34.3 %) with EVAR vs. 56.7 % (61.3 %) with OR in this group.
  
  
  CONCLUSIONS
  Hospital mortality is an important quality parameter of endovascular and open repair of iAAA and rAAA. Administrative data of a health insurance company can be used to provide representative and comprehensive statements on inhospital mortality.
authors.affiliation: Klinik für Gefäßmedizin, Universitäres Herzzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland. debus@uke.de.
authors.forename: E S
authors.initials: ES
authors.lastname: Debus
authors.affiliation: Klinik für Vaskuläre und Endovaskuläre Chirurgie, Universitätsklinikum Münster, Münster, Deutschland.
authors.forename: G
authors.initials: G
authors.lastname: Torsello
authors.affiliation: Klinik für Gefäßmedizin, Universitäres Herzzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
authors.forename: C-A
authors.initials: CA
authors.lastname: Behrendt
authors.affiliation: DAK - Gesundheit, Hamburg, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Petersen
authors.affiliation: DIGG der Deutschen Gesellschaft für Gefäßchirurgie und Gefäßmedizin, Berlin, Deutschland.
authors.forename: R T
authors.initials: RT
authors.lastname: Grundmann
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000401:mortality* / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality* / Q000601:surgery*; D057510:Endovascular Procedures / Q000401:mortality*; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality*; D008297:Male; D009313:National Health Programs / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000401:mortality*; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D012955:Societies, Medical / Q000706:statistics & numerical data*
keywords: Abdominal aortic aneurysm; Administrative data; Endovascular repair; Mortality; Open repair