Prevalence and 30-day mortality of aortitis among Medicare beneficiaries undergoing unruptured abdominal aortic aneurysm repair

Abstract

Background

The US News & World Report's Best Hospitals Procedures and Conditions ratings aim to assess hospital performance for routine inpatient care. Aortitis is a complicating factor for abdominal aortic aneurysm (AAA) repair, but aortitis diagnoses are not currently an exclusion criteria for the AAA repair rating. We assessed 30-day mortality among patients with aortitis during AAA repair to determine whether aortitis should be an exclusion criterion.

Methods

We used the Medicare Beneficiary Summary File and Inpatient Limited Data Sets from January 1, 2019, to December 1, 2022. We included all encounters for AAA repair with a diagnosis code for unruptured AAA. We excluded encounters with a diagnosis code for ruptured AAA. We calculated the prevalence of aortitis (defined using International Classification of Diseases, 10th edition, codes) in this population, and used log-linear regression to compare the age- and sex-adjusted risk of 30-day mortality in patients with aortitis vs those without aortitis. We reported the adjusted risk ratio and 95% confidence interval.

Results

There were 51,508 AAA repair encounters. The prevalence of aortitis was 2.3% (1167/51,508); 30-day mortality occurred in 37/1167 (3.2%) encounters with an aortitis diagnosis vs 998/50,341 (2.0%) without aortitis (adjusted risk ratio, 1.50; 95% confidence interval,1.09-2.07; P = .01).

Conclusions

AAA repair with concurrent aortitis should be excluded from quality outcome measures.