Findings from Stanford University Yields New Data on Medicare and Medicaid (Midterm Outcomes of Open Descending Thoracic Aortic Repair in More Than…

Findings from Stanford University Yields New Data on Medicare and Medicaid (Midterm Outcomes of Open Descending Thoracic Aortic Repair in More Than 5,000 Medicare Patients)

By a News Reporter-Staff News Editor at Insurance Weekly News -- Current study results on Medicare and Medicaid have been published. According to news reporting originating from Stanford, California, by VerticalNews correspondents, research stated, "Diseases involving the descending thoracic aorta (DTA) represent a heterogeneous substrate with a variety of therapeutic options. Although thoracic endovascular aortic repair has been increasingly applied to DTA disease, open surgical repair is ostensibly more durable."

Our news editors obtained a quote from the research from Stanford University, "A total of 5,578 patients who underwent open DTA repair (Current Procedural Terminology code 33875) from 1999 to 2010 were identified from the Medicare database; 5,489 patients had complete data. Survival was assessed with Kaplan-Meier analysis. Cox regression determined predictors of death. Hospital and surgeon volume and variability were modeled, and their association with survival assessed. Median survival after open DTA repair was only 4.3 years (95% confidence interval: 4.0 to 4.6). The likelihood of death varied significantly by certain aortic diseases: aortic rupture and acute aortic dissection patients had the highest early mortality. Survival beyond 180 days was best for patients with acute aortic dissection and isolated thoracic aortic aneurysm, and lowest for patients with thoracoabdominal aneurysm and aortic rupture. Hospital and surgeon volume, as well as inter-hospital and intersurgeon variability, had associations with overall survival. Open DTA repair has treated a spectrum of aortic diseases in Medicare beneficiaries. Overall mortality was high, predominately confined to the initial postoperative hazard phase. Independent hospital and surgeon effects, hospital and surgeon volume, and a more recent date of surgery correlated with improved survival, while increased operative urgency and complexity correlated with worse outcomes."

According to the news editors, the research concluded: "These observations argue for regionalization of DTA treatment for Medicare patients in specialized centers to concentrate expertise, which should translate into better outcomes."

For more information on this research see: Midterm Outcomes of Open Descending Thoracic Aortic Repair in More Than 5,000 Medicare Patients. Annals of Thoracic Surgery, 2015;100(6):2087-2094. Annals of Thoracic Surgery can be contacted at: Elsevier Science Inc, 360 Park Ave South, New York, NY 10010-1710, USA. (Elsevier - www.elsevier.com; Annals of Thoracic Surgery - www.journals.elsevier.com/annals-of-thoracic-surgery/)

The news editors report that additional information may be obtained by contacting J.M. Schaffer, Stanford University, Dept. of Cardiothorac Surg, Sch Med, Stanford, CA 94305, United States. Additional authors for this research include B. Lingala, M.P. Fischbein, M.D. Dake, Y.J. Woo, R.S. Mitchell and D.C. Miller.

Keywords for this news article include: Stanford, Hospital, California, Cardiology, United States, Health Policy, Aortic Dissection, Medicare and Medicaid, North and Central America,

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