Abstract
Objective Existing literature on unplanned reoperation (UR) after vascular surgery is limited. The frequency of 30-day UR and its association with other adverse outcomes was analyzed. Methods Patients who underwent vascular procedures in the American College of Surgeons National Surgical Quality Improvement Program (2012) were abstracted. UR, captured by a distinct variable now available in the data set, and its association with complications, readmissions, mortality, and failure to rescue (FTR) were analyzed using bivariate and multivariate methods. Results Among 35,106 patients, 3545 URs were performed on 2874 patients. The overall UR rate was 10.1%. Among patients who underwent URs, approximately 80.4%, 15.8%, and 3.8% had one, two, and three or more reoperations, respectively; 39.4% of URs occurred after initial discharge. Median time to UR was 7 days but varied by procedure. Procedures with the highest UR rates were embolectomy (18.2%), abdominal bypass (14.4%), and open procedures for peripheral vascular disease (13.8%). Common indications for UR were hemorrhage, graft failure or infection, thromboembolic events, and wound complications. Patients with URs had higher rates of subsequent complications (49.9% vs 19.9%; P <.001), readmission (41.8% vs 7.0%; P <.001), and mortality (8.0% vs 2.5%; P <.001) than those not undergoing URs. FTR was more likely among patients who had a UR (13.6% vs 9.3%; P <.001); this varied within procedure groups. After multivariate adjustment, UR was independently associated with mortality in an incremental fashion (for one UR: adjusted odds ratio, 2.0; 95% confidence interval, 1.7-2.5; for two or more URs: adjusted odds ratio, 3.1; 95% confidence interval, 2.2-4.2). Conclusions URs within 30 days are frequent among patients undergoing vascular surgery and are associated with worse outcomes, including mortality and FTR.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 730-736 |
| Number of pages | 7 |
| Journal | Journal of Vascular Surgery |
| Volume | 63 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2016 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Surgery
- Cardiology and Cardiovascular Medicine
Cite this
Unplanned reoperations after vascular surgery Presented (podium) at the Forty-third Annual Symposium of the Society for Clinical Vascular Surgery, Miami, Fla, March 29-April 2, 2015. / Kazaure, Hadiza S.; Chandra, Venita; Mell, Matthew.
In: Journal of Vascular Surgery, Vol. 63, No. 3, 01.03.2016, p. 730-736.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Unplanned reoperations after vascular surgery Presented (podium) at the Forty-third Annual Symposium of the Society for Clinical Vascular Surgery, Miami, Fla, March 29-April 2, 2015.
AU - Kazaure, Hadiza S.
AU - Chandra, Venita
AU - Mell, Matthew
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Objective Existing literature on unplanned reoperation (UR) after vascular surgery is limited. The frequency of 30-day UR and its association with other adverse outcomes was analyzed. Methods Patients who underwent vascular procedures in the American College of Surgeons National Surgical Quality Improvement Program (2012) were abstracted. UR, captured by a distinct variable now available in the data set, and its association with complications, readmissions, mortality, and failure to rescue (FTR) were analyzed using bivariate and multivariate methods. Results Among 35,106 patients, 3545 URs were performed on 2874 patients. The overall UR rate was 10.1%. Among patients who underwent URs, approximately 80.4%, 15.8%, and 3.8% had one, two, and three or more reoperations, respectively; 39.4% of URs occurred after initial discharge. Median time to UR was 7 days but varied by procedure. Procedures with the highest UR rates were embolectomy (18.2%), abdominal bypass (14.4%), and open procedures for peripheral vascular disease (13.8%). Common indications for UR were hemorrhage, graft failure or infection, thromboembolic events, and wound complications. Patients with URs had higher rates of subsequent complications (49.9% vs 19.9%; P <.001), readmission (41.8% vs 7.0%; P <.001), and mortality (8.0% vs 2.5%; P <.001) than those not undergoing URs. FTR was more likely among patients who had a UR (13.6% vs 9.3%; P <.001); this varied within procedure groups. After multivariate adjustment, UR was independently associated with mortality in an incremental fashion (for one UR: adjusted odds ratio, 2.0; 95% confidence interval, 1.7-2.5; for two or more URs: adjusted odds ratio, 3.1; 95% confidence interval, 2.2-4.2). Conclusions URs within 30 days are frequent among patients undergoing vascular surgery and are associated with worse outcomes, including mortality and FTR.
AB - Objective Existing literature on unplanned reoperation (UR) after vascular surgery is limited. The frequency of 30-day UR and its association with other adverse outcomes was analyzed. Methods Patients who underwent vascular procedures in the American College of Surgeons National Surgical Quality Improvement Program (2012) were abstracted. UR, captured by a distinct variable now available in the data set, and its association with complications, readmissions, mortality, and failure to rescue (FTR) were analyzed using bivariate and multivariate methods. Results Among 35,106 patients, 3545 URs were performed on 2874 patients. The overall UR rate was 10.1%. Among patients who underwent URs, approximately 80.4%, 15.8%, and 3.8% had one, two, and three or more reoperations, respectively; 39.4% of URs occurred after initial discharge. Median time to UR was 7 days but varied by procedure. Procedures with the highest UR rates were embolectomy (18.2%), abdominal bypass (14.4%), and open procedures for peripheral vascular disease (13.8%). Common indications for UR were hemorrhage, graft failure or infection, thromboembolic events, and wound complications. Patients with URs had higher rates of subsequent complications (49.9% vs 19.9%; P <.001), readmission (41.8% vs 7.0%; P <.001), and mortality (8.0% vs 2.5%; P <.001) than those not undergoing URs. FTR was more likely among patients who had a UR (13.6% vs 9.3%; P <.001); this varied within procedure groups. After multivariate adjustment, UR was independently associated with mortality in an incremental fashion (for one UR: adjusted odds ratio, 2.0; 95% confidence interval, 1.7-2.5; for two or more URs: adjusted odds ratio, 3.1; 95% confidence interval, 2.2-4.2). Conclusions URs within 30 days are frequent among patients undergoing vascular surgery and are associated with worse outcomes, including mortality and FTR.
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UR - http://www.scopus.com/inward/citedby.url?scp=84959485813&partnerID=8YFLogxK
U2 - 10.1016/j.jvs.2015.09.046
DO - 10.1016/j.jvs.2015.09.046
M3 - Article
C2 - 26553950
AN - SCOPUS:84959485813
VL - 63
SP - 730
EP - 736
JO - Journal of Vascular Surgery
JF - Journal of Vascular Surgery
SN - 0741-5214
IS - 3
ER -