Complex endovascular treatment of intact aortic aneurysms: An analysis of health insurance claims data
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Complex endovascular treatment of intact aortic aneurysms: An analysis of health insurance claims data. / Behrendt, C-A; Rieß, H C; Schwaneberg, T; Heidemann, F; Tsilimparis, N; Larena-Avellaneda, A-A; Diener, H; Kölbel, T; Debus, E S.
in: GEFASSCHIRURGIE, Jahrgang 23, Nr. Suppl 1, 2018, S. 32-38.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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T1 - Complex endovascular treatment of intact aortic aneurysms: An analysis of health insurance claims data
AU - Behrendt, C-A
AU - Rieß, H C
AU - Schwaneberg, T
AU - Heidemann, F
AU - Tsilimparis, N
AU - Larena-Avellaneda, A-A
AU - Diener, H
AU - Kölbel, T
AU - Debus, E S
PY - 2018
Y1 - 2018
N2 - Background: The complex endovascular repair of aortic aneurysms and dissections with fenestrated or branched stent grafts (FB-EVAR) remains challenging for interventional vascular surgery. To date, the evidence regarding treatment patterns and outcome measures consists of single center studies; however, it might be reasonable to validate results with multicenter real-world evidence.Methods: Health insurance claims data from Germany's third largest insurance provider, DAK-Gesundheit, were used to determine outcomes following FB-EVAR of non-ruptured thoracic aorta (TA) or thoracoabdominal including pararenal abdominal (TAA) aorta. The study included patients operated between January 2008 and April 2017.Results: Included were 984 patients (18.1% female) who underwent FB-EVAR. Patients with treatment of the TA were younger (71.7 vs. 73.2 years, p < 0.001) and more often female (38.5% vs. 17.0%, p < 0.001) as compared to patients with treatment of TAA. In the TA group peripheral arterial disease was less frequent compared to the TAA group (67.3% vs. 80.4%, p = 0.036). Mortality was significantly (p < 0.001) higher following repair of the TAA compared to the TA at discharge (17.3% vs. 4.6%), at 30 days (26.9% vs. 8.2%) and at 90 days (34.6% vs. 10.1%). Patients with treatment of the TAA suffered more often from stroke as compared to the TA group (7.7% vs. 1.2%, p = 0.002).Conclusion: In this large-scale German analysis of claims data, multicenter real-world evidence was different from single center studies regarding patient risk-factors and outcome measures. Validated multicenter registry studies could help to further investigate this topic in times of increasing procedures.
AB - Background: The complex endovascular repair of aortic aneurysms and dissections with fenestrated or branched stent grafts (FB-EVAR) remains challenging for interventional vascular surgery. To date, the evidence regarding treatment patterns and outcome measures consists of single center studies; however, it might be reasonable to validate results with multicenter real-world evidence.Methods: Health insurance claims data from Germany's third largest insurance provider, DAK-Gesundheit, were used to determine outcomes following FB-EVAR of non-ruptured thoracic aorta (TA) or thoracoabdominal including pararenal abdominal (TAA) aorta. The study included patients operated between January 2008 and April 2017.Results: Included were 984 patients (18.1% female) who underwent FB-EVAR. Patients with treatment of the TA were younger (71.7 vs. 73.2 years, p < 0.001) and more often female (38.5% vs. 17.0%, p < 0.001) as compared to patients with treatment of TAA. In the TA group peripheral arterial disease was less frequent compared to the TAA group (67.3% vs. 80.4%, p = 0.036). Mortality was significantly (p < 0.001) higher following repair of the TAA compared to the TA at discharge (17.3% vs. 4.6%), at 30 days (26.9% vs. 8.2%) and at 90 days (34.6% vs. 10.1%). Patients with treatment of the TAA suffered more often from stroke as compared to the TA group (7.7% vs. 1.2%, p = 0.002).Conclusion: In this large-scale German analysis of claims data, multicenter real-world evidence was different from single center studies regarding patient risk-factors and outcome measures. Validated multicenter registry studies could help to further investigate this topic in times of increasing procedures.
U2 - 10.1007/s00772-018-0387-7
DO - 10.1007/s00772-018-0387-7
M3 - SCORING: Review article
C2 - 29950794
VL - 23
SP - 32
EP - 38
JO - GEFASSCHIRURGIE
JF - GEFASSCHIRURGIE
SN - 0948-7034
IS - Suppl 1
ER -