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The Impact of a Hospitalís Teaching Status on Outcomes After TEVAR
Edgar Aranda-Michel1, James Brown1, Sarah Yousef1, Derek Serna-Gallegos1, Forzon Navid1, Valentino Bianco1, Yisi Wang1, George Arnaoutakis2, Ibrahim Sultan1.
1UPMC, Pittsburgh, PA, USA, 2University of Florida, Gainesville, FL, USA.

The Impact of a Hospitalís Teaching Status on Outcomes After TEVAR
Edgar, JB, SY, DSG, FN, Val, Yisi Wang, George, IS
Objective: TEVAR has been increasingly utilized for acute Type B aortic dissections (TBAD) and descending thoracic aortic aneurysms (TAA). Most reports are single institution studies limited by sample size. The objective of this study was to leverage a national database to review outcomes after TEVAR at teaching versus non-teaching hospitals
Methods: The national readmission database was used to analyze TEVAR patients and readmissions between 2011 and 2017. ICD 9 and 10 codes were used to identify patients undergoing a TEVAR for an acute TBAD or TAA. Logistic regression was used for mortality and readmission.
Results: A total of 23,614 TEVAR procedures were performed, with 85.5% occurring at a teaching hospital. Patients at teaching hospitals were more likely to be younger, more likely to be treated for TBAD, more likely to have diabetes, heart failure and chronic kidney disease (Table 1). Initial 30 day / in hospital mortality was similar (P = 0.99) between teaching (5.59%) and non-teaching (5.60%) hospitals. Ninety-day readmissions were similar between teaching and non-teaching cohorts (28.4% vs 30.0%, P=0.10). On logistic regression, hospital teaching status was not a significant predictor for 90-day readmission (P=0.05) or 90-day mortality (P = 0.99).
Conclusion: Hospital teaching status did not affect patient outcomes after TEVAR for acute TBAD or TAA. These data may be relevant as use of TEVAR expands to hospitals with limited resources.

Table 1
Table 1. Baseline differences between patients undergoing TEVAR at teaching versus non-teaching hospitals
VariableNon-Teaching(N = 2,547)Teaching(N = 14,516)P - Value
Female1030 (40.43%)5989 (41.26%)0.43
Age72.00 (62.00-79.00)69.00 (58.00-77.00)<.001
Etiology<0.01
Type B Dissection991(38.92%)6651(45.82%)
Aneurysm1556(61.08%)7865(54.18%)
Comorbidities
Diabetes499 (19.58%)3133 (21.58%)0.02
Coagulation Disorders242 (9.50%)1856 (12.79%)<.001
Congestive Heart Failure227 (8.92%)1702 (11.73%)<.001
Cerebral Vascular Disease218 (8.57%)1517 (10.45%)0.00
COPD734 (28.83%)3593 (24.75%)<.001
Chronic Kidney Disease394 (15.46%)2735 (18.84%)<.001
Resident of Hospital State2337 (91.76%)12866 (88.63%)<.001
Hospital Cost (1000 USD)39.19 (27.77-58.80)45.53 (30.95-68.33)<.001
Variables presented as count (frequency) and median (Interquartile range 1-3) for categorical and continuous variables respectively.
COPD - Chronic Obstructive Pulmonary Disease

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