They Live in a Desert but Are They Deserted? Analysis of Veteran Patients Undergoing Endovascular Aortic Aneurysm Repair Who Live in Food Deserts

Abstract

Previous studies have shown that food deserts (FDs) are associated with worse postoperative outcomes, low medication adherence, and decreased screening. We hypothesized that similar to previous studies, FDs would be associated with increased postoperative complications and increased loss to follow-up in a population undergoing endovascular aortic aneurysm repair (EVAR). We retrospectively analyzed a single Veterans Administration Hospital for all patients who underwent an EVAR from January 2010 to December 2021. Patients’ factors collected included age, albumin, body mass index, past medical history, smoking status, medications, anesthesia type, access type, postoperative complications, endoleak history, limb stenosis, readmission rates, and FD status. FD assignment was defined using US Department of Agriculture’s Food Access Research Atlas. The Student t-test** and Fisher exact test* were used. A total of 241 EVARs occurred over the 11-year period. Most patients were male (99.2%), with an average age of 71.7 ± 7.02 years. A total of 57 (23.7%) lived in an FD. Of those living in an FD, there was no statistically significant difference in comorbidities nor ethnicities between the 2 groups. The mean preoperative albumin (3.8 ± 0.37 vs 3.7 ± 0.36; P = .41**) or the mean body mass index (27.4 ± 4.8 vs 28.2 ± 5.0; P = .92**) differed between FD vs non-FD, respectively. There was no statistical difference in postoperative complications including return to the operating room, hemodynamic instability, respiratory failure, acute kidney injury, readmission rates, wound infections, or urinary tract infections. In addition, there was no statistical difference in endoleak rates, limb stenosis, or loss to follow-up rates between the groups. Contrary to previous studies, our data indicate that in a veteran population living in an FD was not associated with increased rate of infection, worse postoperative outcomes, or increased loss to follow-up. Further studies are needed to assess food access impact on EVAR outcomes.