Conversion from an outpatient to an inpatient setting after an endovascular treatment for lower extremity artery disease.

INTRODUCTION Outpatient endovascular treatment (EVT) for lower extremity artery disease (LEAD) is increasing. Some patients will, nonetheless, unexpectedly stay hospitalized for the night after the procedure. The purpose of this study was to identify the factors associated with a conversion from an outpatient setting (OS) to an inpatient setting (IS). METHODS From April 2017 to August 2019, we performed 745 EVT for LEAD. Patients scheduled for a same-day discharge procedure were retrospectively analyzed. The factors potentially associated with a conversion to an IS were assessed. Results are expressed as odds ratio (OR) with 95% confidence intervals. RESULTS Among the 198 (26.6%) patients scheduled for outpatient EVT, mean age was 70.8±14.1 years old, 34.3% had an ASA score≥3 and 38.4% presented a chronic limb-threatening ischemia. Twenty-eight patients (14.1%) were converted from an OS to IS. Univariate analysis found that Rutherford stage≥4 (OR=5.09 [2.11-12.27], p<.001), high blood pressure (OR=3.19 [1.06-9.63], p=.040), ASA score≥3 (OR=3.61 [1.58-8.24], p=.002), duration of procedure ≥90 min (OR=2.36, [1.03-5.39], p=.042), anterograde puncture (OR=2.94, [1.30-6.66], p=.009), arrival in the operating room ≥12:00 (OR=13.05, [5.29-32.17], p<.001) and general anesthesia (OR=3.89, [1.20-12.62], p=.024) were associated with a conversion. The multivariate analysis revealed that an arrival in the operative room ≥12:00 (OR=11.71, [3.85-35.60], p<.001) and general anesthesia (OR=6.76, [1.28-35.82], p=.009) were independent factors associated with a conversion. CONCLUSION Arrival in the operative room after 12:00 and general anesthesia represent two independent correctible factors associated with the risk of OS failure. No factor directly related to comorbidities or the LEAD severity was identified.