Outcomes for Popliteal Artery Injury Repair after Discharge: A Large-scale Population-based Analysis

Background Although short-term outcomes for popliteal artery injury after endovascular versus open repair appear similar, studies on outcomes after discharge are limited. We evaluated popliteal artery injury repair in a population-based dataset. We hypothesized that post-discharge outcomes for open repair are superior to endovascular repair. Methods Patients with popliteal artery injury were identified in the California Office of Statewide Health Planning and Development 2007-2014 discharge database. Popliteal artery injury and other lower-extremity injuries were identified using ICD-9-CM diagnosis codes. Procedure codes were evaluated to identify open repair, endovascular repair, fasciotomy, and amputation. Primary outcomes were mortality or amputation. The association between repair method and each outcome was evaluated with logistic regression. Post-discharge amputation and all-cause mortality were evaluated using survival analysis. Results Among 769 patients with popliteal artery injury, open repair occurred in 456 (59.3%), endovascular repair in 37 (4.3%), combined endovascular and open in 18 (2.3%), and non-operative management in 258 (33.6%). Fasciotomy was performed more frequently in open than endovascular repair (p=0.001) during index admission. Amputation rate was also increased in open repair but this was not significant (p=0.196). Arterial thromboembolus during index admission was more likely after endovascular or combined endovascular and open compared with open (24.3%, 55.6%, 16.7%, respectively, p

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