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Mortality and Morbidity After Open Surgical Lower Extremity Revascularization in Patients With Peripheral Artery Disease and Concurrent Abdominal Stoma.
Leverich, Matthew; Afifi, Ahmed M; Ren, Gang; Nazzal, Munier; Osman, Mohamed.
Afiliación
  • Leverich M; Department of Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
  • Afifi AM; Department of Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
  • Ren G; Department of Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
  • Nazzal M; Department of Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
  • Osman M; Department of Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
Am Surg ; 90(12): 3216-3222, 2024 Dec.
Article en En | MEDLINE | ID: mdl-39031071
ABSTRACT

OBJECTIVES:

Patients with peripheral artery disease (PAD) often require treatment with open lower extremity revascularization (LER). Patients with PAD often have other comorbidities and associated conditions that affect procedural outcomes, including abdominal stomas. The aim of this work is to investigate the impact that stomas may have on postoperative outcomes and complications.

METHODS:

We performed a 5-year (2016-2020) analysis of the Nationwide Readmission Database. We identified all adult patients undergoing open LER. These patients were categorized into 2 groups stoma and no-stoma. Propensity score matching (11) was used to control for demographics and comorbidities. Index admission outcomes and readmission rate were examined.

RESULTS:

212,275 open LER patients were identified. A matched cohort of 3088 patients (11 stoma vs no-stoma) was obtained. Patients with stomas had higher rates of several postoperative complications acute posthemorrhagic anemia (29.1%, P < 0.01), acute kidney injury (21.4%, P < 0.001), index sepsis (10.3%, P < 0.001), and index SSI (2.8%, P < 0.001). There were no significant statistical differences between the 2 groups for acute myocardial infarction. Those with stomas had worse

outcomes:

greater in-hospital mortality (4.7%, P < 0.05), length of stays (median 7 days, P < 0.001), total charges (median 108,037 dollars, P < 0.001), discharges to long-term care facilities (30.8%, P < 0.001), discharges to their own homes needing home health care (30.1%, P < 0.001), 30-day readmission rates (23.2%, P < 0.01), and 30-day readmission mortality (6.1%, P < 0.01).

CONCLUSIONS:

Concurrent abdominal stoma is associated with increased postoperative morbidity and mortality after open LER. Further prospective studies are needed to validate these results.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Extremidad Inferior / Enfermedad Arterial Periférica Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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 / Extremidad Inferior / Enfermedad Arterial Periférica Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos