Frank M. Parker

Preoperative statin therapy is associated with improved outcomes and resource utilization in patients undergoing aortic aneurysm repair

INTRODUCTION This study hypothesized that preoperative statin therapy would have a protective effect on patients undergoing elective abdominal aortic aneurysm (AAA) repair and that the risk-reduction effect of these agents would result in a reduction in subsequent total hospital costs. METHODS All patients who underwent an elective endovascular AAA repair (EVAR) or open AAA repair (OAR) between 2004 and 2007 were retrospectively reviewed. Clinical end points included postoperative days, length of hospital stay, postoperative complications (myocardial infarction, stroke, renal failure, hemorrhage, pneumonia, urinary tract infection, wound infection), and 30-day mortality. The financial end point was total hospital cost associated with the procedure. RESULTS We identified 401 patients, consisting of 173 EVAR patients (43%) and 228 OAR (57%). Despite a higher Society for Vascular Surgery risk score, the EVAR statin cohort had significantly reduced postoperative days (1.9 +/- 0.2 vs 2.3 +/- 0.3, P < .05) and hospital length of stay (2.3 +/- 0.3 vs 2.8 +/- 0.4, P < .05) compared with the nonstatin EVAR cohort. Postoperative complications (4.4% vs 14.7%, P < .05) and the mortality rate (0.0% vs 5.9%, P < .05) were significantly decreased in the OAR statin cohort compared with the nonstatin OAR cohort and trended to be decreased in the EVAR statin group. Statin therapy translated into a lower total cost per patient of

Cost per day of patency: Understanding the impact of patency and reintervention in a sustainable model of healthcare

3,205 for EVAR and

The impact of socioeconomic factors on outcome and hospital costs associated with femoropopliteal revascularization.

3,792 for OAR (P < .05). CONCLUSION With respect to both clinical outcome measures and subsequent resource utilization, statin therapy is associated with a beneficial effect in patients undergoing elective AAA repair. These data suggest that preoperative statin therapy should be an integral part of the risk optimization for patients undergoing AAA repair.

Correlation of cerebral oximetry with internal carotid artery stump pressures in carotid endarterectomy

BACKGROUND Healthcare resource utilization is an understudied aspect of vascular surgery. Initial cost of a given procedure is not an accurate reflection of resource utilization because it does not account for procedural durability and efficacy. Herein we describe an amortized cost model that accounts for procedural costs, durability, and re-intervention costs. METHODS A cost model was developed using patency data endpoints and total hospital costs (direct and indirect) associated with an inital revascularization and subsequent re-interventions. This model was applied to a retrospective database of femoropopliteal reconstructions. One hundred and eighty-three open cases were compared with 198 endovascular cases; and the endpoints of initial cost, amortized cost at 12 months, and assisted patency were examined. RESULTS The open and endovascular cases were not statistically different with respect to indication, patient co-morbid profiles, or post-procedural pharmacotherapy. Primary assisted patency was better in the open revascularization group at 12 months (78% versus 66%, P < .01). There was a statistically significant higher initial cost for open reconstruction when compared with endovascular (

A contemporary rural trauma center experience in blunt traumatic aortic injury.

12,389 +/-

The Association of Periprocedural Hypertension and Adverse Outcomes in Patients Undergoing Catheter-Directed Thrombolysis

408 versus

Endovascular Stent Exclusion of a Hepatic Artery Pseudoaneurysm

6,739 +/-

Coil Embolization of Persistent False Lumen After Type A Dissection Repair

206, P < .001). However, at 12 months post-procedure, the initial cost benefit was lost for endovascular patients (

Role of statin therapy and angiotensin blockade in patients with asymptomatic moderate carotid artery stenosis

229 +/-

Impact of psychological factors on objective ambulatory measures in patients with intermittent claudication

106 versus