Leveraging the Vascular Quality Initiative to reduce length of stay following elective carotid endarterectomy and endovascular aortic aneurysm repair.

Objective: Length of stay (LOS) is a key quality metric for the Society for Vascular Surgery's Vascular Quality Initiative (VQI). In 2021, our hospital was an outlier for 'prolonged LOS' after carotid endarterectomy (CEA >1 day; 67% vs target 21%) and endovascular aortic aneurysm repair (EVAR >2 days; 36% vs target 22%). In response, we launched a quality improvement initiative to reduce LOS following elective CEA and EVAR.

Implementation of a preoperative frailty screening and optimization pathway for vascular surgery patients is associated with decreased 30-day readmission.

Objective: Frailty is characterized by decreased physiological reserve and vulnerability to adverse events in the presence of a stressor such as surgery. We prospectively implemented a preoperative frailty screening and optimization pathway for patients undergoing vascular surgery and assessed its impact on postoperative outcomes.

Methods: As part of an ongoing quality improvement initiative, surgical frailty was assessed prospectively in all patients undergoing inpatient surgery using the Risk Analysis Index (RAI).