Variations in abdominal aortic aneurysm care : a report from the International consortium of vascular registries
Background: This project by the ICVR (International Consortium of Vascular Registries), a collaboration of 11 vascular surgical quality registries, was designed to evaluate international variation in the contemporary management of abdominal aortic aneurysm (AAA) with relation to recommended treatmen...
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Uppsala universitet, Kärlkirurgi
2016
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ftuppsalauniv:oai:DiVA.org:uu-311975 2023-05-15T16:49:05+02:00 Variations in abdominal aortic aneurysm care : a report from the International consortium of vascular registries Beck, AW Sedrakyan, A Mao, J Venermo, M Faizer, R Debus, S Behrendt, CA Scali, S Altreuther, M Schermerhorn, M Beiles, B Szeberin, Z Eldrup, N Danielsson, G Thomson, I Wigger, P Björck, Martin Cronenwett, JL Mani, Kevin International Consortium of Vascular Registries 2016 application/pdf http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-311975 https://doi.org/10.1161/CIRCULATIONAHA.116.024870 eng eng Uppsala universitet, Kärlkirurgi Circulation, 0009-7322, 2016 http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-311975 doi:10.1161/CIRCULATIONAHA.116.024870 PMID 27784712 ISI:000390558300007 info:eu-repo/semantics/openAccess Cardiac and Cardiovascular Systems Kardiologi Article in journal info:eu-repo/semantics/article text 2016 ftuppsalauniv https://doi.org/10.1161/CIRCULATIONAHA.116.024870 2023-02-23T21:37:18Z Background: This project by the ICVR (International Consortium of Vascular Registries), a collaboration of 11 vascular surgical quality registries, was designed to evaluate international variation in the contemporary management of abdominal aortic aneurysm (AAA) with relation to recommended treatment guidelines from the Society for Vascular Surgery and the European Society for Vascular Surgery. Methods: Registry data for open and endovascular AAA repair (EVAR) during 2010 to 2013 were collected from 11 countries. Variations in patient selection and treatment were compared across countries and across centers within countries. Results: Among 51 153 patients, 86% were treated for intact AAA (iAAA) and 14% for ruptured AAA. Women constituted 18% of the entire cohort (range, 12% in Switzerland–21% in the United States; P<0.01). Intact AAAs were repaired at diameters smaller than recommended by guidelines in 31% of men (<5.5 cm; range, 6% in Iceland–41% in Germany; P<0.01) and 12% of women with iAAA (<5 cm; range, 0% in Iceland–16% in the United States; P<0.01). Overall, use of EVAR for iAAA varied from 28% in Hungary to 79% in the United States (P<0.01) and for ruptured AAA from 5% in Denmark to 52% in the United States (P<0.01). In addition to the between-country variations, significant variations were present between centers in each country in terms of EVAR use and rate of small AAA repair. Countries that more frequently treated small AAAs tended to use EVAR more frequently (trend: correlation coefficient, 0.51; P=0.14). Octogenarians made up 23% of all patients, ranging from 12% in Hungary to 29% in Australia (P<0.01). In countries with a fee-for-service reimbursement system (Australia, Germany, Switzerland, and the United States), the proportions of small AAA (33%) and octogenarians undergoing iAAA repair (25%) were higher compared with countries with a population-based reimbursement model (small AAA repair, 16%; octogenarians, 18%; P<0.01). In general, center-level variation within ... Article in Journal/Newspaper Iceland Uppsala University: Publications (DiVA) Circulation 134 24 1948 1958 |
institution |
Open Polar |
collection |
Uppsala University: Publications (DiVA) |
op_collection_id |
ftuppsalauniv |
language |
English |
topic |
Cardiac and Cardiovascular Systems Kardiologi |
spellingShingle |
Cardiac and Cardiovascular Systems Kardiologi Beck, AW Sedrakyan, A Mao, J Venermo, M Faizer, R Debus, S Behrendt, CA Scali, S Altreuther, M Schermerhorn, M Beiles, B Szeberin, Z Eldrup, N Danielsson, G Thomson, I Wigger, P Björck, Martin Cronenwett, JL Mani, Kevin International Consortium of Vascular Registries Variations in abdominal aortic aneurysm care : a report from the International consortium of vascular registries |
topic_facet |
Cardiac and Cardiovascular Systems Kardiologi |
description |
Background: This project by the ICVR (International Consortium of Vascular Registries), a collaboration of 11 vascular surgical quality registries, was designed to evaluate international variation in the contemporary management of abdominal aortic aneurysm (AAA) with relation to recommended treatment guidelines from the Society for Vascular Surgery and the European Society for Vascular Surgery. Methods: Registry data for open and endovascular AAA repair (EVAR) during 2010 to 2013 were collected from 11 countries. Variations in patient selection and treatment were compared across countries and across centers within countries. Results: Among 51 153 patients, 86% were treated for intact AAA (iAAA) and 14% for ruptured AAA. Women constituted 18% of the entire cohort (range, 12% in Switzerland–21% in the United States; P<0.01). Intact AAAs were repaired at diameters smaller than recommended by guidelines in 31% of men (<5.5 cm; range, 6% in Iceland–41% in Germany; P<0.01) and 12% of women with iAAA (<5 cm; range, 0% in Iceland–16% in the United States; P<0.01). Overall, use of EVAR for iAAA varied from 28% in Hungary to 79% in the United States (P<0.01) and for ruptured AAA from 5% in Denmark to 52% in the United States (P<0.01). In addition to the between-country variations, significant variations were present between centers in each country in terms of EVAR use and rate of small AAA repair. Countries that more frequently treated small AAAs tended to use EVAR more frequently (trend: correlation coefficient, 0.51; P=0.14). Octogenarians made up 23% of all patients, ranging from 12% in Hungary to 29% in Australia (P<0.01). In countries with a fee-for-service reimbursement system (Australia, Germany, Switzerland, and the United States), the proportions of small AAA (33%) and octogenarians undergoing iAAA repair (25%) were higher compared with countries with a population-based reimbursement model (small AAA repair, 16%; octogenarians, 18%; P<0.01). In general, center-level variation within ... |
format |
Article in Journal/Newspaper |
author |
Beck, AW Sedrakyan, A Mao, J Venermo, M Faizer, R Debus, S Behrendt, CA Scali, S Altreuther, M Schermerhorn, M Beiles, B Szeberin, Z Eldrup, N Danielsson, G Thomson, I Wigger, P Björck, Martin Cronenwett, JL Mani, Kevin International Consortium of Vascular Registries |
author_facet |
Beck, AW Sedrakyan, A Mao, J Venermo, M Faizer, R Debus, S Behrendt, CA Scali, S Altreuther, M Schermerhorn, M Beiles, B Szeberin, Z Eldrup, N Danielsson, G Thomson, I Wigger, P Björck, Martin Cronenwett, JL Mani, Kevin International Consortium of Vascular Registries |
author_sort |
Beck, AW |
title |
Variations in abdominal aortic aneurysm care : a report from the International consortium of vascular registries |
title_short |
Variations in abdominal aortic aneurysm care : a report from the International consortium of vascular registries |
title_full |
Variations in abdominal aortic aneurysm care : a report from the International consortium of vascular registries |
title_fullStr |
Variations in abdominal aortic aneurysm care : a report from the International consortium of vascular registries |
title_full_unstemmed |
Variations in abdominal aortic aneurysm care : a report from the International consortium of vascular registries |
title_sort |
variations in abdominal aortic aneurysm care : a report from the international consortium of vascular registries |
publisher |
Uppsala universitet, Kärlkirurgi |
publishDate |
2016 |
url |
http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-311975 https://doi.org/10.1161/CIRCULATIONAHA.116.024870 |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
Circulation, 0009-7322, 2016 http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-311975 doi:10.1161/CIRCULATIONAHA.116.024870 PMID 27784712 ISI:000390558300007 |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.1161/CIRCULATIONAHA.116.024870 |
container_title |
Circulation |
container_volume |
134 |
container_issue |
24 |
container_start_page |
1948 |
op_container_end_page |
1958 |
_version_ |
1766039147996250112 |