Cargando…

Incidence and Predictors of Cardiovascular Complications and Death after Vascular Surgery

BACKGROUND: Patients undergoing arterial vascular surgery are considered at increased risk for post-operative complications. OBJECTIVE: To assess the incidence and predictors of complications and death, as well as the performance of two models of risk stratification, in vascular surgery. METHODS: Th...

Descripción completa

Detalles Bibliográficos
Autores principales: Smeili, Luciana Andrea Avena, Lotufo, Paulo Andrade
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Cardiologia 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651410/
https://www.ncbi.nlm.nih.gov/pubmed/26421535
http://dx.doi.org/10.5935/abc.20150113
_version_ 1782401634019573760
author Smeili, Luciana Andrea Avena
Lotufo, Paulo Andrade
author_facet Smeili, Luciana Andrea Avena
Lotufo, Paulo Andrade
author_sort Smeili, Luciana Andrea Avena
collection PubMed
description BACKGROUND: Patients undergoing arterial vascular surgery are considered at increased risk for post-operative complications. OBJECTIVE: To assess the incidence and predictors of complications and death, as well as the performance of two models of risk stratification, in vascular surgery. METHODS: This study determined the incidence of cardiovascular complications and deaths within 30 days from surgery in adults. Univariate comparison and logistic regression assessed the risk factors associated with the outcomes, and the receiver operating characteristic (ROC) curve assessed the discriminatory capacity of the revised cardiac risk index (RCRI) and vascular study group of New England cardiac risk index (VSG-CRI). RESULTS: 141 patients (mean age, 66 years; 65% men) underwent the following surgeries: carotid (15); lower limbs (65); abdominal aorta (56); and others (5). Cardiovascular complications and death occurred within 30 days in 28 (19.9%) and 20 (14.2%) patients, respectively. The risk predictors were: age, obesity, stroke, poor functional capacity, altered scintigraphy, surgery of the aorta, and troponin change. The scores RCRI and VSG-CRI had area under the curve of 0.635 and 0.639 for early cardiovascular complications, and 0.562 and 0.610 for death in 30 days. CONCLUSION: In this small and selected group of patients undergoing arterial vascular surgery, the incidence of adverse events was elevated. The risk assessment indices RCRI and VSG-CRI did not perform well for complications within 30 days.
format Online
Article
Text
id pubmed-4651410
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Sociedade Brasileira de Cardiologia
record_format MEDLINE/PubMed
spelling pubmed-46514102015-11-19 Incidence and Predictors of Cardiovascular Complications and Death after Vascular Surgery Smeili, Luciana Andrea Avena Lotufo, Paulo Andrade Arq Bras Cardiol Article BACKGROUND: Patients undergoing arterial vascular surgery are considered at increased risk for post-operative complications. OBJECTIVE: To assess the incidence and predictors of complications and death, as well as the performance of two models of risk stratification, in vascular surgery. METHODS: This study determined the incidence of cardiovascular complications and deaths within 30 days from surgery in adults. Univariate comparison and logistic regression assessed the risk factors associated with the outcomes, and the receiver operating characteristic (ROC) curve assessed the discriminatory capacity of the revised cardiac risk index (RCRI) and vascular study group of New England cardiac risk index (VSG-CRI). RESULTS: 141 patients (mean age, 66 years; 65% men) underwent the following surgeries: carotid (15); lower limbs (65); abdominal aorta (56); and others (5). Cardiovascular complications and death occurred within 30 days in 28 (19.9%) and 20 (14.2%) patients, respectively. The risk predictors were: age, obesity, stroke, poor functional capacity, altered scintigraphy, surgery of the aorta, and troponin change. The scores RCRI and VSG-CRI had area under the curve of 0.635 and 0.639 for early cardiovascular complications, and 0.562 and 0.610 for death in 30 days. CONCLUSION: In this small and selected group of patients undergoing arterial vascular surgery, the incidence of adverse events was elevated. The risk assessment indices RCRI and VSG-CRI did not perform well for complications within 30 days. Sociedade Brasileira de Cardiologia 2015-11 /pmc/articles/PMC4651410/ /pubmed/26421535 http://dx.doi.org/10.5935/abc.20150113 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Article
Smeili, Luciana Andrea Avena
Lotufo, Paulo Andrade
Incidence and Predictors of Cardiovascular Complications and Death after Vascular Surgery
title Incidence and Predictors of Cardiovascular Complications and Death after Vascular Surgery
title_full Incidence and Predictors of Cardiovascular Complications and Death after Vascular Surgery
title_fullStr Incidence and Predictors of Cardiovascular Complications and Death after Vascular Surgery
title_full_unstemmed Incidence and Predictors of Cardiovascular Complications and Death after Vascular Surgery
title_short Incidence and Predictors of Cardiovascular Complications and Death after Vascular Surgery
title_sort incidence and predictors of cardiovascular complications and death after vascular surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651410/
https://www.ncbi.nlm.nih.gov/pubmed/26421535
http://dx.doi.org/10.5935/abc.20150113
work_keys_str_mv AT smeililucianaandreaavena incidenceandpredictorsofcardiovascularcomplicationsanddeathaftervascularsurgery
AT lotufopauloandrade incidenceandpredictorsofcardiovascularcomplicationsanddeathaftervascularsurgery