Conversion From an Outpatient to an Inpatient Setting After an Endovascular Treatment for Lower Extremity Artery Disease.

Aged Anesthesia, General Endovascular Procedures Female Hospitalization Humans Leg / blood supply Male Outpatients Peripheral Arterial Disease / surgery Retrospective Studies
ambulatory conversion endovascular lower extremity artery disease outpatient surgery same-day discharge

Journal

Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941

Informations de publication

Date de publication:
Mar 2022
Historique:
received: 08 08 2021
revised: 05 10 2021
accepted: 05 10 2021
pubmed: 16 11 2021
medline: 12 3 2022
entrez: 15 11 2021
Statut: ppublish

Résumé

Outpatient endovascular treatment (EVT) for lower extremity artery disease (LEAD) is increasing. Some patients will, nonetheless, unexpectedly stay hospitalized for the night after the procedure. The purpose of this study was to identify the factors associated with a conversion from an outpatient setting (OS) to an inpatient setting (IS). From April 2017 to August 2019, we performed 745 EVT for LEAD. Patients scheduled for a same-day discharge procedure were retrospectively analyzed. The factors potentially associated with a conversion to an IS were assessed. Results are expressed as odds ratio (OR) with 95% confidence intervals. Among the 198 (26.6%) patients scheduled for outpatient EVT, mean age was 70.8±14.1 years old, 34.3% had an ASA score≥3 and 38.4% presented a chronic limb-threatening ischemia. Twenty-eight patients (14.1%) were converted from an OS to IS. Univariate analysis found that Rutherford stage≥4 (OR = 5.09 [2.11-12.27], P < 0.001), high blood pressure (OR = 3.19 [1.06-9.63], P = 0.040), ASA score≥3 (OR = 3.61 [1.58-8.24], P = 0.002), duration of procedure ≥90 min (OR = 2.36, [1.03-5.39], P = 0.042), anterograde puncture (OR = 2.94, [1.30-6.66], P = 0.009), arrival in the operating room ≥12:00 (OR = 13.05, [5.29-32.17], P < 0.001) and general anesthesia (OR = 3.89, [1.20-12.62], P = 0.024) were associated with a conversion. The multivariate analysis revealed that an arrival in the operative room ≥12:00 (OR = 11.71, [3.85-35.60], P < 0.001) and general anesthesia (OR = 6.76, [1.28-35.82], P = 0.009) were independent factors associated with a conversion. Arrival in the operative room after 12:00 and general anesthesia represent two independent correctible factors associated with the risk of OS failure. No factor directly related to comorbidities or the LEAD severity was identified.

Sections du résumé

BACKGROUND BACKGROUND
Outpatient endovascular treatment (EVT) for lower extremity artery disease (LEAD) is increasing. Some patients will, nonetheless, unexpectedly stay hospitalized for the night after the procedure. The purpose of this study was to identify the factors associated with a conversion from an outpatient setting (OS) to an inpatient setting (IS).
METHODS METHODS
From April 2017 to August 2019, we performed 745 EVT for LEAD. Patients scheduled for a same-day discharge procedure were retrospectively analyzed. The factors potentially associated with a conversion to an IS were assessed. Results are expressed as odds ratio (OR) with 95% confidence intervals.
RESULTS RESULTS
Among the 198 (26.6%) patients scheduled for outpatient EVT, mean age was 70.8±14.1 years old, 34.3% had an ASA score≥3 and 38.4% presented a chronic limb-threatening ischemia. Twenty-eight patients (14.1%) were converted from an OS to IS. Univariate analysis found that Rutherford stage≥4 (OR = 5.09 [2.11-12.27], P < 0.001), high blood pressure (OR = 3.19 [1.06-9.63], P = 0.040), ASA score≥3 (OR = 3.61 [1.58-8.24], P = 0.002), duration of procedure ≥90 min (OR = 2.36, [1.03-5.39], P = 0.042), anterograde puncture (OR = 2.94, [1.30-6.66], P = 0.009), arrival in the operating room ≥12:00 (OR = 13.05, [5.29-32.17], P < 0.001) and general anesthesia (OR = 3.89, [1.20-12.62], P = 0.024) were associated with a conversion. The multivariate analysis revealed that an arrival in the operative room ≥12:00 (OR = 11.71, [3.85-35.60], P < 0.001) and general anesthesia (OR = 6.76, [1.28-35.82], P = 0.009) were independent factors associated with a conversion.
CONCLUSION CONCLUSIONS
Arrival in the operative room after 12:00 and general anesthesia represent two independent correctible factors associated with the risk of OS failure. No factor directly related to comorbidities or the LEAD severity was identified.

Identifiants

DOI: 10.1016/j.avsg.2021.10.036 PMID: 34780959
pubmed: 34780959
pii: S0890-5096(21)00845-1
doi: 10.1016/j.avsg.2021.10.036
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

96-103

Informations de copyright

Copyright © 2021. Published by Elsevier Inc.

Auteurs

Sébastien Multon (S)

Department of Vascular Surgery, Ambroise Paré University Hospital, Boulogne-Billancourt, France.

Jérémie Jayet (J)

Department of Vascular Surgery, Ambroise Paré University Hospital, Boulogne-Billancourt, France.

Jennifer Canonge (J)

Department of Vascular Surgery, Ambroise Paré University Hospital, Boulogne-Billancourt, France.

Isabelle Javerliat (I)

Department of Vascular Surgery, Ambroise Paré University Hospital, Boulogne-Billancourt, France.

Marc Coggia (M)

Department of Vascular Surgery, Ambroise Paré University Hospital, Boulogne-Billancourt, France.

Raphaël Coscas (R)

Department of Vascular Surgery, Ambroise Paré University Hospital, Boulogne-Billancourt, France; UMR 1018, Inserm-Paris11 - CESP, Versailles Saint-Quentin-en-Yvelines University, Paris-Saclay University, Paul Brousse Hospital, Villejuif, France. Electronic address: rcoscas@gmail.com.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Conversion From an Outpatient to an Inpatient...
questionsmedicales.fr › Anesthésie et analgésie › Anesthésie › Anesthésie générale › Conversion From an Outpatient to an Inpatient...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Procédures endovasculaires › Conversion From an Outpatient to an Inpatient...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Hospitalisation › Conversion From an Outpatient to an Inpatient...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Conversion From an Outpatient to an Inpatient...
questionsmedicales.fr › Régions du corps › Membres › Membre inférieur › Jambe › Conversion From an Outpatient to an Inpatient...
questionsmedicales.fr › Personnes › Patients › Patients en consultation externe › Conversion From an Outpatient to an Inpatient...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Maladies vasculaires périphériques › Maladie artérielle périphérique › Conversion From an Outpatient to an Inpatient...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Conversion From an Outpatient to an Inpatient...