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According to Barmer Health insurance company, surgery on the extended artery has different success – depending on the clinic and method. This is unacceptable.

Hospital report 2018: Risk of death in certain OPS depends on the clinic according to the study

According to Barmer Health insurance company, surgery on the extended artery has different success – depending on the clinic and method. This is unacceptable.

Hospital report 2018: Risk of death in certain OPS depends on the clinic according to the study

In case of surgery on extended abdominal artery, chances of success for patients in German clinics of a health insurance study are not equally good everywhere. The level of risk of death in event of interventions depends on how and where surgery was performed, Barmer health insurance Company shared results of ir annual hospital reports. As a consequence, it demands that interventions be carried out in future only in certified vascular centres or clinics with many cases, since survival rate is higher re.

In Germany, around 200,000 women and men over 65 years are suffering from a sagging of abdominal artery, so-called endovascular (BAA). Most of those affected do not know about it, complaints are dismissed as abdominal pain or as back pain when main artery's sagging is pushed around spine. If vessel wall in area of such an aneurysm, Barmer only 20 percent of patients survive massive loss of blood.

Older men suffer six times more often than women in an aneurysm of abdominal aorta. Also, risk of illness increases with age. Smoking or a family preload increases risk even furr.

According to Barmer, it is to be expected that "due to increasingly progressive ageing of society" re will be more patients with this disease in future – and disease picture is refore gaining in importance in hospital life.

According to hospital report, in year 2016 more than 11,400 patients were operated on abdominal aorta over 65 years. In certified vascular centers and hospitals with high case numbers, death rate after OP was 2.6 percentage points lower than in low-case houses. However, a high-quality operation should not depend on place of residence, Barmer report criticizes.

The surgical method is also crucial

In addition, death rate was reduced by two percentage points three years after a predictable intervention, when surgery was not openly surgical but minimally invasive. Minimally invasive procedures are considered to be gentle, as abdominal cavity does not have to be opened. A wire-reinforced prossis (stent) is introduced from inside into extension of aorta, as explained by German Society for Vascular Surgery and vascular medicine. While open operation is always possible, such a stent prossis can only be used in certain cases. It is also detrimental to regular, often lifelong monitoring.

The Barmer has also identified significant regional differences in surgical procedures. In Saxony between 2014 and 2016 almost 86 percent of patients were operated minimally invasively on abdominal aorta, in Lower Saxony it was 69 percent and in Saarland 61 percent.

As a basis for report, Barmer draws on its own statements data of its approximately 8.4 million insured people, which is equivalent to about ten percent of population. The data included information after period from 2006 to 2017.

Criticism of study came from German hospital company. She argues that a few patients with a higher personal risk could lead to such divergent mortality rates. Different surgical techniques would be used depending on medical need.

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