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Home > Vascular Annual Meeting^® > SS23. The Incidence of Infectious Complications...

SS23. The Incidence of Infectious Complications After Elective Vascular Surgery in the United States

Todd R. Vogel, Viktor Y. Dombrovskiy, Jeffrey L. Carson, Paul B. Haser, Stephen F. Lowry, Alan M. Graham
UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ

OBJECTIVES: To evaluate the incidence and socio-demographics of postoperative infectious complications after elective vascular surgery, to define vascular procedures with the greatest risk of developing nosocomial infections, and to assess the impact of infection on utilization.

METHODS: The Nationwide Inpatient Sample (2002-2006) was utilized to identify major vascular procedures by ICD-9-CM codes. Infectious complications including pneumonia (PNA), urinary tract infections (UTI), postoperative sepsis, and surgical site infections (SSI) were identified. Case mix-adjusted rates for age, race, gender, and comorbidities were calculated using a multivariate logistic regression model with infectious complications as an outcome.

RESULTS: 870,778 elective vascular surgical procedures were evaluated with an overall infection rate of 3.70%. Open abdominal aortic surgery had the greatest rate of postoperative infections compared to open thoracic and aorta-iliac-femoral bypass surgeries. Thoracic endografting infectious complication rates were two times greater than EVAR (p<.0001). PNA was the most common infectious complication after open aortic surgery (6.63%) where UTI was the most common after TEVAR (2.86%) and EVAR (1.31%). Infectious complications were greater in octogenarians (p<.0002), women (p<.0001), and blacks (p<.0001 compared to whites and Hispanics). Nosocomial infections significantly increased length of stay (days) and charges (13.8±15.4 vs. 3.5±4.2; $37,834±42,905 vs. $11,851±11,816, respectively, p<0.001).

CONCLUSIONS: Among elective vascular surgical procedures, open aortic surgery and CEA have, respectively, the greatest and the least risk for postoperative infectious complications. Women, octogenarians, and blacks have the highest risk of infectious complications after elective vascular surgery. Hospital infectious complications dramatically increase resource utilization and strategies reducing nosocomial complications would offer significant cost savings.

AUTHOR DISCLOSURES: T.R. Vogel, American Heart Association; V.Y. Dombrovskiy, None; J.L. Carson, National Heart, Lung, and Blood Institute; P.B. Haser, None; S.F. Lowry, National Institute of General Medical Sciences; A.M. Graham, None.

Table 1.