Vascular Surgery

Non-home discharge after ALI revascularization portends higher 1-year mortality

In 769 ALI patients who survived to discharge, 37.3% were discharged to non-home settings. One-year mortality was higher after non-home discharge versus home discharge (21.2% vs 7.6%). Non-home discharge correlated with age, frailty, non-ambulation, prior stroke, hypoalbuminemia, severe ischemia, and certain procedural factors. Discharge location rose stepwise with cumulative risk burden (18% with 0–2 factors up to 92% with ≥6 factors). 1

NLP-driven AAA surveillance increased imaging, visits, repairs, and revenue

An NLP algorithm screened 7,516,363 imaging reports and identified 16,923 patients for AAA review. The program produced 1,008 new imaging studies, 1,080 clinic visits, and 47 AAA repairs after nurse-navigator follow-up. The initiative generated a direct contribution margin of $3,330,928 and expanded successfully to a new hospital. Workflow optimization reduced navigator FTE while maintaining case identification and follow-up activity. 2

AAA associated with higher cancer risk; EVAR linked to modestly higher risk than open repair

Meta-analysis of 12 studies found AAA patients had increased overall cancer risk (RR 1.69, 95% CI 1.28–2.22). Elevated risks included respiratory, hepatic, bladder, pancreatic, and hematologic malignancies. EVAR was associated with a slightly higher cancer risk than open repair (RR 1.11, 95% CI 1.06–1.16). Findings do not prove causality and may reflect detection bias, shared risk factors, or procedural surveillance differences. 3