{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T21:23:05Z","timestamp":1740172985358,"version":"3.37.3"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2018,7,3]],"date-time":"2018-07-03T00:00:00Z","timestamp":1530576000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Surgery Research and Practice"],"published-print":{"date-parts":[[2018,7,3]]},"abstract":"<jats:p><jats:italic>Introduction<\/jats:italic>. The aim of the study was to examine common sequences of causes of readmissions among those patients with multiple hospital admissions, high-impact users, after abdominal aortic aneurysm (AAA) repair and to focus on strategies to reduce long-term readmission rate. <jats:italic>Methods<\/jats:italic>. The patient cohort (2006\u20132009) included patients from Hospital Episodes Statistics, the national administrative data of all NHS English hospitals, and followed up for 5 years. Group-based trajectory modelling and sequence analysis were performed on the data. <jats:italic>Results<\/jats:italic>. From a total of 16,973 elective AAA repair patients, 18% (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>3055<\/mml:mn><\/mml:mrow><\/mml:math>) were high-impact users. The high-impact users among ruptured abdominal aortic aneurysm (rAAA) repair constituted 17.3% of the patient population (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>4144<\/mml:mn><\/mml:mrow><\/mml:math>). There were 2 subtypes of high-impact users, short-term (7.2%) with initial high readmission rate following by rapid decline and chronic high-impact (10.1%) with persistently high readmission rate. Common causes of readmissions following elective AAA repair were respiratory tract infection (7.3%), aortic graft complications (6.0%), unspecified chest pain (5.8%), and gastrointestinal haemorrhage (4.8%). However, high-impact users included significantly increased number of patients with multiple readmissions and distinct sequences of readmissions mainly consisting of COPD (4.7%), respiratory tract infection (4.7%), and ischaemic heart disease (3.3%). <jats:italic>Conclusion<\/jats:italic>. A significant number of patients were high-impact users after AAA repair. They had a common and distinct sequence of causes of readmissions following AAA repair, mainly consisting of cardiopulmonary conditions and aortic graft complications. The common causes of long-term mortality were not related to AAA repair. The quality of care can be improved by identifying these patients early and focusing on prevention of cardiopulmonary diseases in the community.<\/jats:p>","DOI":"10.1155\/2018\/5468010","type":"journal-article","created":{"date-parts":[[2018,7,3]],"date-time":"2018-07-03T19:48:04Z","timestamp":1530647284000},"page":"1-11","source":"Crossref","is-referenced-by-count":2,"title":["Common Sequences of Emergency Readmissions among High-Impact Users following AAA Repair"],"prefix":"10.1155","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8728-8729","authenticated-orcid":true,"given":"Ahsan","family":"Rao","sequence":"first","affiliation":[{"name":"Dr Foster Unit, Department of Public Health, Imperial College London, 3 Dorset Rise, London EC4Y 8EN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Bottle","sequence":"additional","affiliation":[{"name":"Dr Foster Unit, Department of Public Health, Imperial College London, 3 Dorset Rise, London EC4Y 8EN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Bicknell","sequence":"additional","affiliation":[{"name":"Department of Surgery, Imperial College London, St. Mary\u2019s Hospital, Praed Street, London W2 1NY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ara","family":"Darzi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Imperial College London, St. Mary\u2019s Hospital, Praed Street, London W2 1NY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Aylin","sequence":"additional","affiliation":[{"name":"Dr Foster Unit, Department of Public Health, Imperial College London, 3 Dorset Rise, London EC4Y 8EN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.09.032"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0087465"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1177\/014107680609900818"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-014-0532-2"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-001667"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.03.260"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-013-2626-7"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000072767.89944.6e"},{"year":"2013","key":"9"},{"volume-title":"HSMR mortality indicators","year":"November 2010","key":"10"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.109.848465"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204113"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-270"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2009.10.003"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2015.05.016"},{"issue":"10","key":"16","first-page":"e392","volume":"18","year":"2012","journal-title":"American Journal of Managed Care"},{"year":"2005","key":"17"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.121208.131413"},{"year":"2009","key":"19"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9531.2010.01227.x"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1097\/mlr.0b013e318053717c"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.1177\/1526602815606937"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0b013e31826b4bfe"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2005.00444.x"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-013-0665-4"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv125"}],"container-title":["Surgery Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/srp\/2018\/5468010.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/srp\/2018\/5468010.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/srp\/2018\/5468010.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,7,3]],"date-time":"2018-07-03T19:48:07Z","timestamp":1530647287000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/srp\/2018\/5468010\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,3]]},"references-count":26,"alternative-id":["5468010","5468010"],"URL":"https:\/\/doi.org\/10.1155\/2018\/5468010","relation":{},"ISSN":["2356-7759","2356-6124"],"issn-type":[{"type":"print","value":"2356-7759"},{"type":"electronic","value":"2356-6124"}],"subject":[],"published":{"date-parts":[[2018,7,3]]}}}