Mortality following operations for lower extremity peripheral arterial disease

oleh: Tracie C Collins, David Nelson, Jasjit S Ahluwalia

Format: Article
Diterbitkan: Dove Medical Press 2010-05-01

Deskripsi

Tracie C Collins1,2, David Nelson3, Jasjit S Ahluwalia1,21Department of Medicine, Division of General Internal Medicine, University of Minnesota Minneapolis, MN, USA; 2Center for Health Equity, University of Minnesota Medical School, Minneapolis, MN, USA; 3Minneapolis VA Medical Center, Center for Chronic Disease Outcomes Research, University of Minnesota, Minneapolis, MN, USABackground: We sought to identify risk factors associated with mortality following surgery for peripheral arterial disease (PAD).Methods: We evaluated the association between levels of control of atherosclerotic risk factors and time to mortality following either lower extremity bypass surgery or lower extremity amputation using Cox proportional hazards regression.Results: Among 796 patients with PAD (defined by an ankle-brachial index [ABI] < 0.9), 230 (28.9%) underwent an operation for PAD (136, lower-extremity bypasses; 111, lower-extremity amputations). Participants were followed for up to six years after their diagnosis of PAD. A total of 107 (46.5% of the 230) died during the period of follow-up. Factors associated with mortality following lower extremity bypass surgery included age 70 years and older hazard ratio [HR] 1.88; 95% confidence interval [CI]: 1.01–3.51) and of African American race (HR 1.94; 95% CI: 1.04–3.62). Renal insufficiency was significantly associated with mortality following lower extremity amputation (HR 2.19; 95% CI: 1.16–4.13). Conclusion: Our data provide information on preoperative risk variables to consider when assessing long-term mortality in persons with PAD who are undergoing surgery for PAD.Keywords: risk factors, mortality, bypass surgery, ankle-brachial index