Mortality and major postoperative complications within 1 year after vascular surgery : a prospective cohort study
Polok, Kamil (Jagiellonian University Medical College (Cracòvia, Polònia))
Biccard, Bruce Mclure (Groote Schuur Hospital (Observatory, Sud-àfrica))
Chan, Matthew T. V. (Chinese University of Hong Kong (Hong Kong, Àsia))
Archbold, R. Andrew (Barts Heart Centre. St. Bartholomew's Hospital (Londres, Regne Unit))
Wang, Chew Yin (University of Malaya (Kuala Lumpur, Malàisia))
Sigamani, Alben (Narayana Hrudayalaya Limited (Karnataka, Índia))
Urrútia, Gerard (Institut de Recerca Sant Pau)
Cruz, Patricia (Hospital General Universitario Gregorio Marañón)
Srinathan, Sadeesh K. (University of Manitoba (Winnipeg, Canadà))
Szalay, David (McMaster University (Ontario, Canadà))
Harlock, John (McMaster University (Hamilton, Canadà))
Tittley, Jacques G. (McMaster University (Ontario, Canadà))
Elias, Fadi (McMaster University (Ontario, Canadà))
Jacka, Michael J. (University of Alberta (Edmonton, Canadà))
Malaga, German (Universidad Peruana Cayetano Heredia)
Berwanger, Otavio (Imperial College London (Londres, Regne Unit))
Studzińska, Dorota (Jagiellonian University Medical College (Cracòvia, Polònia))
Górka, Jacek (Jagiellonian University Medical College (Cracòvia, Polònia))
Montes, Félix R. (Fundación Cardioinfantil Instituto de Cardiología (Bogotà, Colòmbia))
Chow, Clara Kayei (University of Sydney (Sydney, Austràlia))
Ackland, Gareth Lewis (Queen Mary University of London (Londres, Regne Unit))
Dubois, Luc (Western University (Canadà))
Sapsford, Robert J. (Leeds Teaching Hospitals NHDS Trust (Leeds, Regne Unit))
Williams, Colin (Royal Liverpool and Broadgreen University Hospitals Trust (Merseyside, Regne Unit))
Cortés, Olga L. (Fundación Cardioinfantil Instituto de Cardiología (Cundinamarca, Colòmbia))
Devereaux, Philip J. (Population Health Research Institute (Hamilton, Canadà))
Szczeklik, Wojciech (Jagiellonian University Medical College (Cracòvia, Polònia))
Universitat Autònoma de Barcelona

Fecha:	2024
Resumen:	INTRODUCTION Patients undergoing vascular procedures are prone to developing postoperative complications affecting their short-term mortality. Prospective reports describing the incidence of long-term complications after vascular surgery are lacking. OBJECTIVES We aimed to describe the incidence of complications 1 year after vascular surgery and to evaluate an association between myocardial injury after noncardiac surgery (MINS) and 1-year mortality. PATIENTS AND METHODS This is a substudy of a large prospective cohort study Vascular Events in Noncardiac Surgery Patients Cohort Evaluation (VISION). Recruitment took place in 28 centers across 14 countries from August 2007 to November 2013. We enrolled patients aged 45 years or older undergoing vascular surgery, receiving general or regional anesthesia, and hospitalized for at least 1 night postoperatively. Plasma cardiac troponin T concentration was measured before the surgery and on the first, second, and third postoperative day. The patients or their relatives were contacted 1 year after the procedure to assess the incidence of major postoperative complications. RESULTS We enrolled 2641 patients who underwent vascular surgery, 2534 (95. 9%) of whom completed 1-year follow-up. Their mean (SD) age was 68. 2 (9. 8) years, and the cohort was predominantly male (77. 5%). The most frequent 1-year complications were myocardial infarction (224/2534, 8. 8%), amputation (187/2534, 7. 4%), and congestive heart failure (67/2534, 2. 6%). The 1-year mortality rate was 8. 8% (223/2534). MINS occurred in 633 patients (24%) and was associated with an increased 1-year mortality (hazard ratio, 2. 82; 95% CI, 2. 14-3. 72; P <0. 001). CONCLUSIONS The incidence of major postoperative complications after vascular surgery is high. The occurrence of MINS is associated with a nearly 3-fold increase in 1-year mortality.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra, i la creació d'obres derivades, sempre que no sigui amb finalitats comercials i que es distribueixin sota la mateixa llicència que regula l'obra original. Cal que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Myocardial injury after noncardiac surgery ; Postoperative complications ; Vascular surgery
Publicado en:	Polish Archives of Internal Medicine, Vol. 134 Núm. 2 (28 2024) , p. 16645, ISSN 1897-9483

DOI: 10.20452/pamw.16645
PMID: 38164648

9 p, 280.1 KB

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