Abstract 12844: Weekend Admission is Associated With Higher Renal Complications in Thoracic Endovascular Aneurysm Repair for Stanford Type B Aortic Dissection

Abstract

Introduction: A weekend effect characterized by worse perioperative outcomes has been demonstrated in some surgery patients admitted on weekends, as opposed to weekdays. This study aims to examine the weekend effect on outcomes after open surgical repair or thoracic endovascular aneurysm repair (TEVAR) in Stanford Type B Aortic Dissection (TBAD). Methods: Patients who underwent TBAD repair were identified in the National Inpatient Sample (NIS) from 2015-2020 by ICD10-CM/PCS. Open surgery and TEVAR were examined separately. Patients were stratified into two cohorts based on weekday or weekend admission. Significant preoperative differences were present between cohorts, so multivariable logistic regressions were performed comparing in-hospital perioperative outcomes. Adjusted preoperative variables included sex, age, race, socioeconomic status, comorbidity, hospital characteristics, length of stay (LOS), days from admission to operation, and total hospital charge were compared. Results: Among patients who underwent open TBAD repair, 1,321 were admitted on weekdays and 340 on weekends. Among patients who underwent TEVAR after TBAD, there were 2,018 admitted on weekdays and 440 admitted on weekends. There was no difference in open repair outcomes between those admitted on weekdays versus weekends. In the TEVAR cohort, weekend admission has associated with higher acute kidney injury (AKI) (aOR=1.69, 95% CI 1.33-2.15, p<0.01), post-procedural kidney failure (aOR=5.65, 95% CI 1.45-22.06, p=0.01), and transfer to another center (aOR=1.54, 95% CI 1.21-1.96, p<0.01). Also in the TEVAR cohort, weekend admission was associated with longer LOS, longer wait to operation, and higher cost (all p<0.01). Conclusion: Weekend admission is an independent risk factor for higher renal complications patients with TBAD who undergo TEVAR. Eliminating delays in treatment associated with the weekend effect may decrease renal complications, decrease LOS, and decrease cost.