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Regional Anesthesia is Associated with Improved Mortality and Morbidity in Patients with Congestive Heart Failure Undergoing Lower Extremity Amputation.
Chahrour, Mohamad; Chamseddine, Hassan; Kabbani, Loay; Aboul Hosn, Maen.
Afiliación
  • Chahrour M; Division of Vascular Surgery, Department of Surgery, University of Iowa Hospital and Clinics, Iowa, IA.
  • Chamseddine H; Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, MI. Electronic address: hchamse1@hfhs.org.
  • Kabbani L; Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, MI.
  • Aboul Hosn M; Division of Vascular Surgery, Department of Surgery, University of Iowa Hospital and Clinics, Iowa, IA. Electronic address: maen-aboulhosn@uiowa.edu.
Ann Vasc Surg ; 108: 206-211, 2024 Nov.
Article en En | MEDLINE | ID: mdl-38950851
ABSTRACT

BACKGROUND:

While existing literature reports variable results of general anesthesia (GA) and regional anesthesia (RA) in patients undergoing lower extremity amputation (LEA), the effect of RA on patients with congestive heart failure (CHF) has not been explored. This study aims to assess whether the choice of anesthesia plays a role in influencing outcomes within this vulnerable population.

METHODS:

Using the American College of Surgeons National Surgical Quality Improvement Program files between 2005 and 2022, all patients receiving LEA were identified, and the subset of patients with CHF was included. Patient characteristics and 30-day outcomes were compared using χ2 or Fischer's exact test as appropriate for categorical variables and the independent t-test or Mann-Whitney U test as appropriate for continuous variables. The association between anesthesia modality and post-operative outcomes was studied using multivariable logistic regression analysis.

RESULTS:

A total of 5,831 patients (4,779 undergoing GA, 1,052 undergoing RA) with a diagnosis of CHF undergoing LEA were identified. On multivariable logistic regression analysis, RA was associated with lower mortality (adjusted odds ratio [aOR] 0.79, 95% CI 0.65-0.97), pneumonia (aOR 0.76, 95% CI 0.58-0.99), septic shock (aOR 0.64, 95% CI 0.47-0.88), post-operative blood transfusion (aOR 0.82, 95% CI 0.70-0.97), and 30-day readmission (aOR 0.79, 95% CI 0.64-0.97).

CONCLUSIONS:

This study demonstrates that RA for LEA in patients with CHF is associated with decreased morbidity and mortality compared to GA. While furthermore research is needed to confirm this association, RA should be at least considered in CHF patients undergoing LEA when feasible.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Bases de Datos Factuales / Extremidad Inferior / Insuficiencia Cardíaca / Amputación Quirúrgica / Anestesia de Conducción / Anestesia General Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Ann Vasc Surg Asunto de la revista: ANGIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Bases de Datos Factuales / Extremidad Inferior / Insuficiencia Cardíaca / Amputación Quirúrgica / Anestesia de Conducción / Anestesia General Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Ann Vasc Surg Asunto de la revista: ANGIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos