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The Effect of Preoperative Renal Failure on Outcomes Following Infrainguinal Endovascular Interventions for Peripheral Arterial Disease
- Source :
- Journal of Vascular and Interventional Radiology. 32:459-465
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Purpose To analyze the effect of a patient’s renal failure status on acute outcomes after lower extremity endovascular interventions for peripheral artery disease. Materials and Methods A retrospective analysis of the American College of Surgery National Surgical Quality Improvement Program database from 2014 to 2017 was conducted. Patients were included based on current procedural terminology codes. They were divided into renal failure cohorts. Six thousand seven hundred and sixty-five patients were included in the analysis, 11.0% of whom had renal failure. A univariate analysis was performed using chi-squared test or Fischer’s exact test as appropriate. Multivariate logistic regression models were constructed, while controlling for relevant patient factors, to identify the effect of renal failure on several outcomes of interest after the intervention. A sensitivity analysis was performed with a propensity score-matched cohort. Results Patients with renal failure were more likely to have infrapopliteal interventions (38.0% vs 20.9%), critical limb ischemia with tissue loss (73.5% vs 38.9%), diabetes (70.9% vs 52.3%), preoperative wound infection (59.2% vs 30.7%), mortality (5.1% vs 1.3%), prolonged hospital stay (68.5% vs 46.5%), transfusion after the intervention (13.3% vs 9.1%), reoperation (18.3% vs 9.5%), and readmission (24.9% vs 12.6%), compared to patients without renal failure. The multivariate analysis found renal failure to be significant for mortality (odds ratio [OR] = 4.11, 95% confidence interval [CI] = 2.71–6.24), any complication (OR = 2.03, 95% CI = 1.72–2.39), extended length of stay (OR = 1.53, 95% CI = 1.28–1.83), sepsis (OR = 2.37, 95% CI = 1.60–3.51), readmission (OR = 1.89, 95% CI = 1.57–2.29), reoperation (OR = 1.84, 95% CI = 1.48–2.27), major adverse cardiovascular event (OR = 3.50, 95% CI = 2.54–4.84), and major adverse limb event (OR = 1.97, 95% CI = 1.55–2.51). P value was Conclusions Renal failure before the intervention places patients at a significantly elevated risk of morbidity and mortality following endovascular revascularization procedures for peripheral artery disease.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Databases, Factual
Kidney
Risk Assessment
030218 nuclear medicine & medical imaging
Peripheral Arterial Disease
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
Renal Insufficiency
Aged
Retrospective Studies
Univariate analysis
business.industry
Endovascular Procedures
Odds ratio
Critical limb ischemia
Middle Aged
United States
Confidence interval
Hospitalization
Exact test
Treatment Outcome
030220 oncology & carcinogenesis
Retreatment
Cohort
Current Procedural Terminology
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
Complication
business
Subjects
Details
- ISSN :
- 10510443
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Journal of Vascular and Interventional Radiology
- Accession number :
- edsair.doi.dedup.....fbcdbc791d3d3c33068da06da64c14ad