Locoregional Anesthesia is Associated with Reduced Hospital Stay and Need for ICU Care of Elective EVAR Patients in the Vascular Quality Initiative. (Record no. 52)

MARC details
000 -LEADER
fixed length control field 04179nam a22003857a 4500
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 221213s20222022 xxu||||| |||| 00| 0 eng d
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 0741-5214
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code 10.1016/j.jvs.2022.11.043 [doi]
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code S0741-5214(22)02534-4 [pii]
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
PMID 36400363
245 ## - TITLE STATEMENT
Title Locoregional Anesthesia is Associated with Reduced Hospital Stay and Need for ICU Care of Elective EVAR Patients in the Vascular Quality Initiative.
251 ## - Source
Source Journal of Vascular Surgery. 2022 Nov 15
252 ## - Abbreviated Source
Abbreviated source J Vasc Surg. 2022 Nov 15
253 ## - Journal Name
Journal name Journal of vascular surgery
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Year 2022
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Manufacturer FY2023
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Publication date 2022 Nov 15
265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE]
Publication status aheadofprint
266 ## - Date added to catalog
Date added to catalog 2022-12-13
501 ## - WITH NOTE
Local holdings Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520 ## - SUMMARY, ETC.
Abstract CONCLUSION: These data suggest that LR anesthesia is safe and may offer advantages in reducing resource utilization for patients undergoing elective EVAR, primarily based on associations with reduced ICU care and reduced hospital stay. Given these findings, LR may prove an advantageous technique in appropriately selected patient populations. Copyright © 2022. Published by Elsevier Inc.
520 ## - SUMMARY, ETC.
Abstract METHODS: Using the Society for Vascular Surgery-Vascular Quality Initiative database, we retrospectively analyzed all patients who underwent elective EVAR from August 2003-June 2021. Patients were grouped by anesthetic type based on the level of consciousness afforded by the anesthetic: local or regional anesthesia (locoregional, or LR) versus general (GA). Primary outcomes were total postoperative hospital length-of-stay (LOS) and intensive care unit (ICU) LOS. Propensity score matching was used for risk adjustment and to analyze the primary outcomes with confirmatory analysis using logistic or linear regression, as appropriate, in single and multilevel models. Secondary outcomes were 30-day mortality, 1-year mortality, postoperative outcomes, operative time, fluoroscopy time, and reoperation rate. These were analyzed following propensity score matching as well as using logistic regression and Cox proportional hazard regression in single and multilevel models, as appropriate.
520 ## - SUMMARY, ETC.
Abstract OBJECTIVE: It has been shown local or regional anesthetic techniques are a feasible alternative to general anesthesia for endovascular aortic aneurysm repair (EVAR). However, studies to date have shown controversial findings with respect to the benefit of local/regional anesthesia in the elective setting. The objective of this study is to compare postoperative outcomes between local/regional anesthesia and general anesthesia in the setting of elective EVAR, using a large, multicenter database.
520 ## - SUMMARY, ETC.
Abstract RESULTS: 50,809 patients underwent elective EVAR from 2003-2021. Of these, 4,302 repairs used LR (8.5%) and 46,507 (91.5%) were performed under GA. After employing propensity score matching, two groups of 3,027 patients were produced. These showed no significant difference in 30-day mortality (OR: 1.22, p= 0.53), 1-year mortality (HR: 1.06, p=0.62), or any postoperative outcomes. LR was found to be significantly associated with shorter hospital stays (<=2 days) (12.5% vs 14.8%, p=0.01), decreased ICU utilization (19.3% vs 30.6%, p<0.001), decreased operative time (110.8 vs 117.3 min, p<0.001), decreased fluoroscopy time (21.0 vs 22.7 min, p<0.001), and a slight reduction in reoperation rate (1.2% vs 1.9%, p=0.02), which all remained significant following single-level and multilevel multivariate analyses accounting for hospital and physician random effects.
546 ## - LANGUAGE NOTE
Language note English
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element IN PROCESS -- NOT YET INDEXED
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Institution MedStar Washington Hospital Center
656 ## - INDEX TERM--OCCUPATION
Department Vascular Surgery Integrated Residency
657 ## - INDEX TERM--FUNCTION
Medline publication type Journal Article
700 ## - ADDED ENTRY--PERSONAL NAME
Local Authors Kong, Daniel
Institution Code MWHC
Program Vascular Surgery Integrated Residency
Degree MD
Resident year Resident PGY 2
790 ## - Authors
All authors Doyle AJ, Kong DS, Kruger JL, Mix DS, Newhall KA, Stoner MC, Zottola ZR
856 ## - ELECTRONIC LOCATION AND ACCESS
DOI <a href="https://dx.doi.org/10.1016/j.jvs.2022.11.043">https://dx.doi.org/10.1016/j.jvs.2022.11.043</a>
Public note https://dx.doi.org/10.1016/j.jvs.2022.11.043
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Item type description Article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection Home library Current library Date acquired Total Checkouts Full call number Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 12/13/2022   36400363 36400363 12/13/2022 12/13/2022 Journal Article

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