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• W3204408901 abstract "The Society for Vascular Surgery published abdominal aortic aneurysm (AAA) practice guidelines in 2003, 2009, and 2018. In 2014, to use the guidelines and supplement participation in the Vascular Quality Initiative, our department of vascular surgery implemented a quarterly AAA Dashboard (AAAdb) to record the perioperative outcomes and guideline compliance with a focus on intervention appropriateness and procedural follow-up. From the available reported evidence and expert consensus opinions, nine additional criteria for the appropriate treatment of AAA <5 cm in women and <5.5 cm in men were noted, when applicable. The purpose of our study was to evaluate the effects of society and institutional guideline compliance on aortic practice. We performed a retrospective review of elective open and endovascular AAA repairs at a single institution from 2010 to 2018. The AAAdb was implemented in the middle of this period in 2014. The patient demographics, aortic size, indication, type of repair, 30-day mortality, and postoperative and 1-year follow-up imaging findings were analyzed. The primary outcomes were adherence to intervention appropriateness and follow-up guidelines. The categorical factors were summarized using frequencies and percentages and compared using Pearson χ2 tests or Fisher exact tests. Continuous measures were summarized using the mean ± standard deviation and compared between study periods using two-sample t tests. From 2010 to 2018, 1549 patients had undergone elective AAA repair, with 657 before AAAdb implementation and 892 after. No differences were found in the AAA size treated after AAAdb (5.6 ± 1.2 cm vs 5.6 ± 1.1 cm; P = .88). However, the proportion of size-appropriate repairs had increased (64.1% vs 71.3%; P < .003). The proportion of small aneurysm repairs with a documented rationale had increased (64.4% vs 80.5%; P < .001), with rapid disease progression as the most common reason. No difference was found in 30-day mortality (1.2% vs 1.1%; P = .94). Follow-up imaging of endovascular repairs had increased at <60 days postoperative follow-up (76% vs 84%; P = .004) and 1-year follow-up (78% vs 86%; P = .0005). The rate of endoleaks identified at <60 days postoperative follow-up also increased (21% vs 29%; P = .012). AAAdb helped confirm and improve the appropriateness of care and compliance with national and institutional guidelines, including treatment of small AAAs in special circumstances. The AAAdb ensured quality follow-up and surveillance in a high-volume, regional aortic center. Consideration should be given to adding additional criteria to the Society for Vascular Surgery guidelines and Vascular Quality Initiative reporting." @default.
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• W3204408901 date "2021-10-01" @default.
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• W3204408901 title "Effect of an Abdominal Aortic Aneurysm Appropriateness Dashboard on Clinical Practice" @default.
• W3204408901 doi "https://doi.org/10.1016/j.jvs.2021.07.011" @default.
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