# Avoidable injuries after intervention for abdominal aortic aneurysm: An analysis of negligence claims over 15 years in Sweden

## TL;DR

This study analyzes negligence claims in Sweden after abdominal aortic aneurysm surgeries over 15 years, finding that avoidable injuries increased and require better training and prevention strategies.

## Contribution

The study provides insights into the trends and causes of avoidable injuries in AAA interventions, emphasizing the need for improved training and prevention methods.

## Key findings

- Endovascular repair (EVAR) had fewer claims (0.7%) compared to open surgery (1.1%).
- Avoidable injuries increased significantly over time and were economically compensated.
- Spinal cord and intestinal ischemia were the main causes of negligence claims.

## Abstract

Patients, who are subjected to a patient's injury, are legally allowed a compensation for their suffering.

The negligence claims after surgical treatment of abdominal aortic aneurysms (AAA) registered in the National Swedish patient insurance company (Landstingens Ömsesidiga Försäkringsbolag [LÖF]) between 2006 and 2020 were analyzed. More than 95% of negligence claims are covered by LÖF. Special emphasis on avoidable or unavoidable injuries was made.

In 15 years 17,000 abdominal aortic interventions were recorded in the Swedish vascular register (SWEDVASC), where vascular interventions in the whole country of Sweden are registered. A total of 151 negligence claims (0.9%) were reported to the insurance company. Available clinical information in the company’s file of the claims was analyzed. The SWEDVASC data on AAA treatment were accessible.

The number of Endovascular repair (EVAR) increased significantly, but the total number of interventions decreased. There were less claims after EVAR (0.7%) compared to open surgery (1.1%). There was an increase in avoidable injuries that were economically compensated (p = 0.02). Spinal cord ischemia and intestinal ischemia were dominating causes for claims

The increase in the number of avoidable injuries should have an impact on how to train and support colleagues under education and efforts to diminish the injuries are essential. To develop methods to diminish the risk for non-avoidable complications is important.