The Endurant Stent-Graft U.S. Clinical Trial: 2-Year AAA Diameter Outcomes Are Predicted by 6-Month Volume Outcomes

Abstract

formed to evaluate rates and predictors of 30-day readmission from a multicenter trial data set. Methods: We analyzed the PREVENT III data set of 1404 CLI patients undergoing LEB at 83 North American centers. The primary end point was readmission 30 days of discharge. Secondary end points included graft patency and limb salvage evaluated in the context of readmission. Results: We analyzed 1356 patients, of these, 23 (1.7%) died inhospital and were excluded from re-admission analyses. Overall, 327 of 1333 patients (24.5%) were readmitted 30 days of discharge. Reasons for readmission included 127 (39%) wound infections in the index leg, 75 (23%) nonvascular reasons, 68 (20.9%) additional procedures in the index leg, and 19 graft failures (5.8%). Univariate predictors are shown in the Table. Adjusted independent predictors of 30-day readmission included wound infection (odds ratio [OR], 4.1; 95% confidence interval [CI], 3.0-5.4; P .0001), renal failure (OR, 4.1; 95% CI, 1.9-8.8; P .0004), early lost patency (OR, 1.9; 95% CI, 1.2-2.9; P .003), dialysis (OR, 1.8; 95% CI, 1.2-2.6; P .003), and female gender (OR, 1.3; 95% CI, 1.0-1.8; P .03). Patients readmitted 30 days had lower rates of limb salvage at 1 year (78% 2.4% vs 91% 0.9%, P .0001). Thirty-day readmission was predictive of limb loss (HR, 2.25; 95% CI, 1.6-3.1; P .0001) at 1 year, after adjustment for other factors. Conclusions: Readmission after LEB for CLI is common (24%) and associated with defined clinical predictors. Readmission is associated with long-term limb loss. These data provide benchmark values for this complex patient population and may prove useful as disease-specific bundling strategies are derived.