Aneurisma dell'aorta addominale (non rotto): volume annuale di interventi chirurgici


Indice

Descrizione indicatore

L’indicatore ci consente di calcolare il numero di interventi chirurgici di riparazione di aneurisma dell’aorta addominale non rotto eseguiti in un anno in una struttura ospedaliera (indicatore di "volume").

Come si legge

L’indicatore si riferisce al grado di "competenza" e di "sicurezza" delle cure prestate. 
Più alto è il numero di interventi chirurgici di riparazione di aneurisma dell’aorta addominale non rotto eseguiti in una struttura ospedaliera, maggiore è il grado di esperienza della struttura stessa e la sicurezza del trattamento offerto.

Descrizione generale

L’Aneurisma dell’Aorta Addominale (AAA) è una dilatazione dell’aorta nella sua porzione addominale.
L’AAA è raro al di sotto dei 50 anni ma la prevalenza aumenta con l’età, interessando circa il 5-10% degli uomini tra i 65 e 79 anni. Inoltre negli uomini è 3 volte più frequente che nelle donne.
Importanti fattori di rischio sono il fumo di sigaretta e l’ipertensione.
La maggior parte degli AAA sono asintomatici; la diagnosi è spesso casuale e può avvenire mediante visita medica (rilievo di una “massa" addominale pulsante ad ogni battito cardiaco) o mediante esami come ecografie, radiografie o TAC, eseguiti per altri motivi.
Non sempre l'AAA deve essere corretto chirurgicamente.
Poiché il rischio di rottura aumenta proporzionalmente alle dimensioni ed alla velocità di crescita, attualmente l'indicazione al trattamento chirurgico si ha in presenza di aneurismi di diametro ≥5,5 cm o con rapido accrescimento (>1.0 cm per anno) o ancora con aspetti morfologici indicanti un elevato rischio di rottura. Inoltre, il trattamento è sempre indicato qualora l'aneurisma dia sintomi quali dolore addominale e/o lombare, segni di compressione delle strutture circostanti, etc.

Valutazione istituzionale

Il Gruppo di lavoro del Programma Nazionale Esiti ha identificato la seguente soglia minima di volume di attività: 100 procedure/anno.

Codici ICD-9-CM selezionati

Sono inclusi tutti i ricoveri, in regime ordinario, con diagnosi principale o secondaria di aneurisma dell’aorta addominale senza rottura (ICD9-CM 441.4) e con le seguenti procedure in qualsiasi campo:
  • resezione dell'aorta con anastomosi (ICD-9-CM 38.34);
  • resezione dell’aorta addominale con sostituzione (ICD-9-CM 38.44);
  • altra asportazione dell’aorta addominale (ICD-9-CM 38.64);
  • impianto endovascolare di graft nell’aorta addominale (ICD-9-CM 39.71). 
Il volume di ricoveri per interventi chirurgici è calcolato su base annuale, riferito all’anno di dimissione del ricovero.

Consulta le strutture sanitarie che effettuano in un anno il maggior numero di interventi chirurgici di aneurisma dell'aorta addominale non rotto


Approfondisci l'indicatore relativo alla mortalità a 30 giorni dall’intervento chirurgico di aneurisma addominale non rotto

Fonte del dato

Programma Nazionale Esiti 2018, indicatore 112. 
Confronto tra strutture calcolato su dati 2017.

Nota bene: per tener conto di errori di attribuzione, sono escluse dall'analisi le strutture con volumi di attività molto bassi (min 5/anno).

Fonte della valutazione istituzionale

Il semaforo è calcolato sulla base del seguente documento ufficiale:

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