Postoperative and amputation-free survival outcomes after femorodistal bypass grafting surgery: Findings from the Department of Veterans Affairs National Surgical Quality Improvement Program

摘要: Abstract Purpose: A noncardiac surgery risk model was used as a means of analyzing variations in postoperative mortality and amputation-free survival for older veterans undergoing femorodistal bypass grafting surgery. Methods: prospective cohort study undertaken 105 Veterans Affairs (VA) hospitals at the time index operation from 1991 to 1995. Each patient linked subsequent hospitalizations, major amputation surgery, through 1999. Logistic regression proportional hazards models were developing indices on basis factors VA National Surgical Quality Improvement Program. total 4288 male 40 years or underwent artificial, vein, situ femoral tibial level. The main outcome measures 30-day survival. Results: Approximately half all patients had undergone an earlier revascularization any level vascular disease. rate 2.1% varied greatly between quartiles (0.6%-5.2%). In median 44.3 months follow-up, surviving 17,694 1147 (26.7%) amputation, 1913 (44.6%) died. overall probability 88% 1 year 63% 5 years; 1- 5-year (any sided) limb salvage rates 87% 74%, respectively, who femoropopliteal procedure, compared with 77% 63%, procedure. When death combined end points, 1, 3, 7.5 56%, 29%, respectively. Patients best 20% scores observed mean 30% higher than poorest risk. Conclusion: Risk derived preoperative workup may be use clinicians assessing communicating prognosis. Risk-adjustment outcomes is critical evaluating future disease management initiatives advanced peripheral arterial (J Vasc Surg 2001;34:283-90.)