Abstract:
BACKGROUND:Our goal was to analyze the incidence and risk factors for 30-day postdischarge mortality in patients with vascular disease undergoing major lower extremity amputation. METHODS:We queried the American College of Surgeons National Surgery Quality Improvement Program data set from the years 2005 to 2009 for amputations with vascular disease diagnosis codes. We analyzed in-hospital mortality and postdischarge mortality by year of the study and relative to length of hospital stay. Patients with American Society of Anesthesiologists physical status classification level 5, do-not-resuscitate status, disseminated cancer, and emergent operations were excluded to highlight risk among patients more likely to survive. We compared risk factors for each mortality group using separate multivariate logistic regressions. RESULTS:Our query resulted in 6,188 patients with mean age of 67 ± 14 years; of these, 39.1% were female. Thirty-day mortality was 7.6%; 4.2% in-hospital mortality and 3.4% postdischarge mortality. After postoperative day 14, the majority of deaths were after discharge and the daily death risk was almost constant until postoperative day 30 at around 2.1 per 1000 survivors. The postdischarge death rates were consistent across the 5 years of the study (χ(2): p = 0.59), despite the fact that median hospital length of stay decreased from 12 to 9 days (Kruskal-Wallis: p < 0.001). Preoperative risk factors for postdischarge death included age, functional status, lower serum albumin, serum creatinine level of >1.2 mg/dL, dialysis, serum bilirubin level of >1.0 mg/dL, black race (protective), systemic inflammatory response syndrome, steroid use for chronic condition, impaired sensorium, alcohol abuse, recent weight loss, and dyspnea. CONCLUSIONS:Patients with vascular disease undergoing major amputation are at high risk for postdischarge mortality. This risk is not associated with recent decrease in hospital stay. Systemic comorbid risk factors were identified, thus highlighting the need for adequate medical management of these patients in the 30 days after the operation. Coordination of postdischarge care to ensure management of systemic illness could potentially improve outcomes.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Davenport DL,Ritchie JD,Xenos ESdoi
10.1016/j.avsg.2011.05.012subject
Has Abstractpub_date
2012-02-01 00:00:00pages
219-24issue
2eissn
0890-5096issn
1615-5947pii
S0890-5096(11)00277-9journal_volume
26pub_type
杂志文章abstract:BACKGROUND:The best strategy in the treatment for ruptured abdominal aortic aneurysm (RAAA) is an ongoing matter of debate. Differently from several retrospective studies, recent randomized controlled trials (RCTs) failed to demonstrate the superiority of endovascular repair (EVAR) over open repair (OPEN). The aim of t...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.avsg.2014.03.017
更新日期:2014-08-01 00:00:00
abstract::Small-sized vessels can represent a contraindication to standard endovascular aortic repair (EVAR), and more specifically, aortoiliac deformities resulting from poliomyelitis may add an adjunctive challenge for total endovascular repair. Herein we report a case of a 62-year-old man with a 55 mm abdominal aortic aneury...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2020.07.019
更新日期:2020-11-01 00:00:00
abstract::A Mucorales infection of an external iliac artery stent in a renal transplant patient is described. Following a kidney transplantation operation and an acute rejection of the transplant, an aneurysm developed at the site of the arterial ligation and three stents were inserted. Two months following insertion of the ste...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9007-1
更新日期:2006-03-01 00:00:00
abstract::Mesenteric arterial branch aneurysms are rare. Giant, multiple, mesenteric branch artery aneurysms are even more uncommon, and only a few reports exist in the literature. We describe a 73-year-old asymptomatic female found to have an abdominal bruit and subsequently diagnosed with multiple mesenteric branch artery ane...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2007.03.009
更新日期:2007-05-01 00:00:00
abstract::A 66-year-old man with multiple comorbidities presented with a juxtarenal perianastomotic aortic aneurysm 10 years after open abdominal aortic aneurysm repair. The aneurysmal disease also involved both iliac bifurcations, the right internal iliac artery, the left common femoral artery (CFA) up to its bifurcation, and ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.12.044
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Choosing the optimal treatment modality for patients with recurrent carotid artery stenosis depends upon many variables, including the etiology of the recurrent plaque morphology and the location of the recurrent lesion. The most important considerations for interventions are the safety, short- and long-term...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.07.020
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:The pathophysiological mechanisms that induce postrevascularization edema after femoropopliteal bypass surgery are not completely understood. Reperfusion-associated injury to revascularized tissue and damage to lymphatic structures are both likely to play a role. Aim of this study was to study edema formatio...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.04.010
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Postoperative ischemic colitis (POIC) remains a frequent and extremely severe complication of infrarenal abdominal aorta surgery. However, its diagnosis and treatment are not always consensual because the incidence is very small. The aim of this retrospective study was to evaluate the prognostic factors of s...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.02.054
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:The aim of this study is to present midterm results of thoracic endovascular aortic repair (TEVAR) using scalloped or fenestrated custom-made endovascular grafts (CMEGs) in aortic arch Zones 0 and 1. METHODS:A retrospective review of prospectively collected data involving consecutive patients with aortic ar...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.06.009
更新日期:2020-11-01 00:00:00
abstract::Rupture of a splenic artery aneurysm is a rare event associated with high mortality rates. Aneurysm of the splenic artery associated with fibromuscular dysplasia (FMD) is even rarer, with only 3 previously reported cases. We report a patient with previously undiagnosed FMD who required emergent intervention because of...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.05.016
更新日期:2014-10-01 00:00:00
abstract::Twelve cases of emboli to the renal artery (one of which was recurrent) were reviewed. In seven patients, emboli were unilateral and the opposite kidney was functional. In five patients, emboli were bilateral or occurred in a solitary kidney, leading to anuria. Cardiac rhythm disorders were encountered in eight patien...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60800-5
更新日期:1988-04-01 00:00:00
abstract:BACKGROUND:Overtreatment and overuse of resources are leading causes of rising health care costs. Identification and elimination process of low value services is important in reducing such costs. At many institutions it is routine to send excised plaque after carotid endarterectomy (CEA) for pathology evaluation. With ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.04.065
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:This study examines the outcome of hybrid revascularization combining iliofemoral endarterectomy and iliac artery stenting using covered stents in TransAtlantic Inter-Society Consensus (TASC) C and D aortoiliac occlusive disease (AIOD) involving the common femoral artery (CFA). METHODS:A retrospective revie...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.11.061
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Thoracic endovascular aortic repair (TEVAR) has emerged as a safe and effective alternative to open surgery for treatment of thoracic aortic aneurysms. It has recently been reported that stent-graft coverage of the celiac artery (CA) during TEVAR is associated with a low risk of acute mesenteric ischemia. Ho...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2014.08.001
更新日期:2014-11-01 00:00:00
abstract::Tuberculous aneurysms of the aorta are rare and give rise to various issues related to their diagnosis and treatment. In this article, we report on an exceptional case concerning a patient who presented with a false tuberculous aneurysm of the thoracic aorta and a degenerative aneurysm of the infrarenal abdominal aort...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.12.034
更新日期:2011-07-01 00:00:00
abstract::We present an 18-year-old young man with the diagnosis of infective endocarditis who also suffered from concomitant knee pain. The clinical examination revealed right homonymous hemianopsia and left peroneal neuropathy. Magnetic resonance imaging studies of the knee demonstrated a lobulated saccular aneurysm in the le...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-003-0106-y
更新日期:2004-01-01 00:00:00
abstract::We report a case of superficial femoral artery (SFA) stent fractures (SF) with atypical symptoms and site of disruption. Patient was hospitalized for sudden onset of right thigh pain, nonrelated to steno-obstructive disease. Preoperative ultrasound suspected and computed tomographic angiography (CTA) confirmed multipl...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.06.085
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Elective repair of large abdominal aortic aneurysms (AAAs) is associated with the risk of significant perioperative mortality. When abdominal aneurysm repair is delayed, patients with asymptomatic large AAAs face the risk of death from rupture. In addition to the risk of rupture, the advancing age of the pat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.03.041
更新日期:2015-08-01 00:00:00
abstract::Since December 1985, we have operated upon seven bicycle racers for endofibrosis of the external iliac artery. In all instances, the athletes had started cycling early in life and were engaged in top level competition by the age of 17. The principal complaint was intermittent claudication of one lower limb at "near-ma...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60123-4
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Iodine contrast medium (ICM) is considered gold standard in endovascular revascularization procedures. However, nephrotoxicity and hypersensitivity to ICM are causes that limit its indiscriminate use. Carbon dioxide (CO2) contrast angiography has been used as an alternative in patients with formal contraindi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.avsg.2014.03.021
更新日期:2014-08-01 00:00:00
abstract::Infrainguinal angioplasty has less initial and long-term success compared with more proximal sites. These suboptimal initial technical results may be related to the heavy calcific burden in the femoral and popliteal arteries and, subsequently, higher incidence of distal dissection. Cutting balloon angioplasty (CBA) is...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-004-0103-9
更新日期:2004-11-01 00:00:00
abstract::Celiac aortic localization of mycotic pseudoaneurysm is serious. The conventional treatment, resection of infected tissues with in situ revascularization, is associated with a high surgical morbid-mortality rate. We report a case of mycotic pseudoaneurysm of the abdominal aorta involving visceral arteries excluded by ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.01.010
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Despite advances in endovascular surgery, lower extremity arterial bypass remains the gold standard treatment for severe, symptomatic peripheral arterial disease (PAD). Patients who are transferred to other hospitals have generally complex medical problems compared to those patients who are directly admitted...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.09.019
更新日期:2017-05-01 00:00:00
abstract::Isolated arterial thrombi complicating inflammatory bowel disease occurs rarely. We encountered a case of a 28-year-old man with Crohn disease who presented with abdominal pain and severe claudication and was found to have an isolated aortoiliac thrombus. Bilateral aortoiliac thromboembolectomies were performed with s...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2012.02.022
更新日期:2012-11-01 00:00:00
abstract::Abdominal aortic dissection (AAD) is a rare pathology and potentially causes rupture or other serious complications. This case report details our experience in endovascular aneurysm repair for AAD in a patient who had a history of coronary bypass surgery. Circumferential dissection of terminal aorta showed stenosis of...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2010.03.033
更新日期:2010-10-01 00:00:00
abstract::We report herein a feasibility study of a minimally invasive endovascular femoropopliteal bypass procedure. The steps include the following: (1) a small groin incision to expose the femoral artery, (2) guidewire passage and mechanical dilatation of the diseased superficial femoral artery, (3) semiclosed endarterectomy...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02015314
更新日期:1995-01-01 00:00:00
abstract::We prospectively evaluated all patients with superficial foot necrosis of 1-3 cm and transcutaneous oxygen tension (TcPO2) values of <30 mmHg who received a sympathectomy as the primary treatment of their vascular occlusive disease. Preoperatively, and every 2-3 days in the postoperative period, measurement of TcPO2 o...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900118
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Common femoral artery is still the most frequently used site for vascular access, mostly for peripheral arterial interventions, and its puncture remains a significant source of patient's morbidity. Manual compression (MC) has been the gold standard for hemostasis after femoral catheterization until recently,...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2018.02.016
更新日期:2018-08-01 00:00:00
abstract::Vascular prosthetic infection is a rare but serious complication of vascular surgery that requires rapid diagnosis and treatment. It is associated with high rates of amputation and death. The diagnosis is difficult when faced with a chronic nonspecific clinical presentation. We report 2 cases showing the diagnostic us...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.07.030
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Antiplatelet treatment prevents cardiovascular events and thrombosis during the endovascular surgery procedure. The aim of this study is to analyze the different antiplatelet treatment used in endovascular procedures in Spain. METHODS:In this investigation we included observational, retrospective, and multi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2011.11.045
更新日期:2013-02-01 00:00:00