Abdominal aortic aneurysm repair in Veterans Affairs medical centers

Abstract Purpose: This study was performed to define outcomes after abdominal ortic aneurysm (AAA) repair in Veterans Affairs (VA) medical centers during fiscal years 1991 through 1993. Methods: With VA patient treatment file data, patients were selected from diagnosis-related groups 110 and 111 and were then classified in a patient management category. In the categories of repair of nonruptured and ruptured AAA, mortality and postoperative complication rates were defined for patients who underwent AAA repair in VA medical centers during the 3-year study period. Results: Hospital mortality rates were 4.86% (166 of 3419) after repair of nonruptured AAA and 47.0% (126 of 268) after repair of ruptured AAA ( p p p = 0.001) and a direct relationship between illness severity and hospital mortality ( p = 0.008). The proportion of ruptured AAAs treated in a hospital was also directly related to individual hospital mortality rates ( p p p Conclusions: Mortality rates after AAA repair in VA hospitals were comparable with those previously reported in other large series. Outcomes for veterans with AAA may improve by referring patients eligible for elective repair to VA medical centers with a greater operative volume or to lower-volume centers that have had excellent results. (J VASC SURG 1996;23:191-200.)