Original Research Articles

AORTA, Article in Press
DOI: 10.12945/j.aorta.2017.17.046

Factors Affecting Follow-Up Compliance in Patients Following Endovascular Aneurysm Repair

Patrick T. Jasinski, Nicos Labropoulos, Olympia G. Christoforatos, Apostolos K. Tassiopoulos

Division of Vascular and Endovascular Surgery, Stony Brook Medicine, Stony Brook, New York, USA

Abstract

Objective: The purpose of this study was to evaluate potential factors affecting patient non-compliance after EVAR.

Method: A retrospective review of patients undergoing elective and emergency endovascular repair for thoracic, abdominal aorta, and iliac artery aneurysms at a single institution from November 2007 to March 2014 was performed. Compliance to follow-up at 1, 6, and 12 months was assessed. Factors evaluated included patient demographics, size of aneurysm, distance between patient’s residence and the outpatient clinic, urgency of surgery and time of the year in which the follow-up visit was scheduled.

Results: During the study period 205 patients (75% male and 25% female) fulfilled the inclusion criteria. The 30-day mortality for elective procedures was 1.1% and 16.1% for emergency procedures (P = .001). Overall mortality at 12 months was 6.3% and 32.3% for elective and emergency procedures respectively (P = .0002). Highest compliance was observed at 1 month with 184 patients (93%) attending. A significant decrease was seen at 6 (n = 102, 54%) and 12 months (n = 89, 48%).  At the 1-year mark, a greater proportion of minority patients were not compliant with follow-up recommendations as compared to Caucasians. Confounders for non-compliance were analyzed with a multivariate analysis and statistical significance was seen in widowed patients as compared to married (P = .008), those with travel distance of >25 miles to the outpatient clinic (P = .032), and those that underwent emergency repair of aneurysms (P = .022) compared to those with elective procedures.

Conclusion: Despite emphasizing the importance of follow-up surveillance after endovascular aortic procedures, almost half of the treated patients were non-compliant. Our study identified travel distance, marital status, and urgency of surgery as factors that may potentially affect patients’ compliance to scheduled follow-up visits.

Cite this article as: Jasinski PT, Labropoulos N, Christoforatos OG, Tassiopoulos AK. Factors Affecting Follow-Up Compliance in Patients Following Endovascular Aneurysm Repair. Aorta (Stamford). DOI: 10.12945/j.aorta.2017.17.046 [In Press]

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