O-123 - ADMINISTRATIVE HEALTHCARE DATA AS AN ADDITION TO THE DUTCH SURGICAL ANEURYSM AUDIT TO EVALUATE MID-TERM REINTERVENTIONS FOLLOWING ABDOMINAL AORTIC ANEURYSM REPAIR: A PILOT STUDY

TOPIC:
Abdominal Aortic Aneurysms
AUTHORS:
Alberga A. (Scientific Bureau, Dutch Institute for Clinical Auditing ~ Leiden ~ Netherlands) , Stangenberger V. (LOGEX b.v. ~ Amsterdam ~ Netherlands) , De Bruin J. (Department of Vascular Surgery, Erasmus University Medical Center ~ Rotterdam ~ Netherlands) , Wever J. (Department of Vascular Surgery, Haga Teaching Hospital ~ The Hague ~ Netherlands) , Wilschut J. (Scientific Bureau, Dutch Institute for Clinical Auditing ~ Leiden ~ Netherlands) , Van Den Brand C. (Emergency Department , Erasmus University MEdical Center ~ Rotterdam ~ Netherlands) , Verhagen H. (Department of Vascular Surgery, Erasmus University Medical Center ~ Rotterdam ~ Netherlands) , Wouters M. (Scientific Bureau, Dutch Institute for Clinical Auditing ~ Leiden ~ Netherlands)
Introduction:
The Dutch Surgical Aneurysm Audit (DSAA) is a nationwide mandatory quality registry that evaluates the perioperative outcomes of abdominal aortic aneurysms (AAAs). The DSAA includes perioperative outcomes that occur up to 30 days, but various complications following AAA repair occur after this period. Therefore, as most patients survive multiple years following an AAA-repair, reliable data on long-term results, especially the durability of EVAR, are of utmost importance. Available data that evaluates mid and long-term reinterventions especially describes data from randomized controlled trials. Observational studies often contain data from centers of excellence, while nationwide data on mid and long-term reinterventions to evaluate the nationwide impact of reinterventions are scarce. A limited registration burden is crucial for quality registries. Therefore, it might be valuable to add administrative healthcare data to the DSAA to evaluate the number and percentage of mid-term reinterventions following intact AAA repair without increasing the registration burden for clinicians. This study assesses the feasibility and potential benefit of administrative healthcare data to evaluate mid-term reinterventions following intact AAA repair.
Methods:
All patients that underwent primary endovascular aneurysm repair (EVAR) or open surgical repair (OSR) for an intact infrarenal AAA between January 2017 and December 2018 were selected from the DSAA. Subsequently, these patients were identified in a database containing reimbursement data. Healthcare activity codes that refer to reinterventions following AAA repair were examined to assess reinterventions within 12 and 15 months following EVAR and OSR. The selected reinterventions were divided into 'vascular-related reinterventions,' and 'abdominal reinterventions'.
Results:
We selected 4043 patients from the DSAA, and 2059 (51%) patients could be identified in the administrative healthcare database. Reintervention rates of 10.4% following EVAR and 9.5% following OSR within 12 months (p=0.719), and 11.5% following EVAR and 10.8% following OSR within 15 months (p=0.785) were reported. More vascular reinterventions were detected within 12 months following EVAR compared to OSR (9.2% vs. 4.6%; p=0.009). In addition, more abdominal reinterventions were detected within 12 months following OSR compared to EVAR (6.2% vs. 1.6%; p<0.001). Similar results were found when examining the reinterventions that occurred within 15 months, which confirms similar results compared to observational studies and prospective trials on this matter.
Conclusion:
Administrative healthcare data as an addition to the DSAA is potentially beneficial to evaluate mid-term reinterventions following intact AAA repair without increasing the registration burden for clinicians. Further validation is necessary before reliable implementation of this tool is warranted.