Endovascular repair is a feasible option for superficial femoral artery injuries: a comparative effectiveness analysis
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ORIGINAL ARTICLE
Endovascular repair is a feasible option for superficial femoral artery injuries: a comparative effectiveness analysis Sean Degmetich1 · Megan Brenner1,2,3 · Matthew Firek1 · Bishoy Zakhary1 · Bruno C. Coimbra1 · Raul Coimbra1,3 Received: 3 October 2020 / Accepted: 21 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To compare outcomes between open (OR) and endovascular repair following superficial femoral artery (SFA) injuries. Methods This is a cross-sectional study querying the 2012–2014 National Inpatient Sample for SFA injuries. Patients were grouped into OR and stent-graft placement (SGP). Primary outcome was in-hospital mortality. Secondary outcomes included hospital length of stay (HLOS), fasciotomy and amputation rate, and cost. Wilcoxon rank-sum, Kruskal–Wallis, Chi-squared test with Bonferroni adjustment were used as appropriate; p 0.05
490 (21.7%)
Mechanism Blunt
745 (39.9%)
230 (59.0%)
0.05
1.7 ± 1.7
Tiered count Score 0–1
1090 (58.4%)
195 (50.0%)
> 0.05
1285 (57.0%)
Score 2–4
680 (36.5%)
150 (38.5%)
> 0.05
830 (36.8%)
Score 5 +
95 (5.1%)
45 (11.5%)
> 0.05
140 (6.2%)
APRDRG severity Extreme loss of function
645 (34.6%)
120 (30.8%)
> 0.05
765 (33.9%)
Major loss of function
715 (38.3%)
120 (30.8%)
> 0.05
835 (37.0%)
Moderate loss of function
410 (22.0%)
110 (28.2%)
> 0.05
520 (23.0%)
Minor loss of functions
95 (5.1%)
40 (10.3%)
> 0.05
135 (6.0%)
APRDRG risk of mortality Extreme likelihood of dying
295 (15.8%)
75 (19.2%)
> 0.05
370 (16.4%)
Major likelihood of dying
470 (25.2%)
50 (12.8%)
> 0.05
520 (23.1%)
Moderate likelihood of dying
335 (18.0%)
95 (24.4%)
> 0.05
430 (19.1%)
Minor likelihood of dying
765 (41.0%)
170 (43.6%)
> 0.05
935 (41.5%)
OR, Open repair; SGP, Stent-graft placement; SFA, Superficial femoral artery; NIS, National Inpatient Sample; APRDRG, All Patient Refined Diagnosis Related Group grade *Numerical values were compared via a version of the Wilcoxon rank-sum test modified for complex survey data. p values shown for categorical variables are from Rao–Scott Chi-squared tests performed in a pairwise manner
a
Includes Asian, Pacific Islander, and any other which does not fall into any of the listed racial groups
13
Endovascular repair is a feasible option for superficial femoral artery injuries: a comparative… Table 3 Outcomes of the OR and SGP groups following SFA injuries Outcomes
Open repair (OR, n = 1865)
Stent-graft placement (SG, n = 390)
p value*
All SFAs (N = 2255)
Mortality HLOS: [day, median (IQR)] Cost: median IQR Days to fasciotomy from admission: (day, mean ± SD) Fasciotomy Lower limb amputation Lower extremity Compartment syndrome Peroneal nerve injury Tibial nerve injury
70 (3.8%) 8 (4–19) $35,847 $19,535–64,256 0.5 ± 1.8
15 (3.8%) 6 (3–20) $37,547 $19,431–59,354 0.4 ± 0.5
> 0.05 > 0.05 > 0.05 > 0.05
85 (3.7%) 8 (4–16) $35,929 $19,502–63,203 0.5 ± 1.8
660 (35.4%) 75 (4.0%)
60 (15.4%) NAa
0.05
720
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