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Outcomes of surgical revascularization for lower extremity arterial thromboembolism in patients with advanced malignancy.

Publication ,  Journal Article
Bennett, KM; Scarborough, JE; Shortell, CK; Cox, MW
Published in: J Vasc Surg
October 2014

OBJECTIVE: The objective of this study was to describe the outcomes of surgical revascularization for lower extremity arterial thromboembolism in patients with advanced malignancy. METHODS: The 2005-2011 American College of Surgeons National Surgical Quality Improvement Program database was used for this study. Preoperative characteristics and postoperative outcomes of patients with known advanced malignancy who underwent surgical revascularization for lower extremity arterial thromboembolic disease were assessed and compared with those of patients without known advanced malignancy. Parsimonious multivariate logistic regression analysis was used to determine the independent association between advanced malignancy and 30-day postoperative mortality and morbidity after adjustment for demographic characteristics, acute and chronic comorbid disease burden, history of peripheral arterial disease, functional and nutritional status, acuity of presentation, and procedure type. RESULTS: The study included 136 patients with advanced malignancy who underwent surgical revascularization for lower extremity arterial thromboembolism for analysis (65% thromboembolectomy, 26% thromboendarterectomy, and 22% bypass grafting). The 30-day mortality and morbidity rates in these patients were 30.2% and 38.2%, respectively. Compared with patients without advanced malignancy, patients with advanced malignancy had a significantly greater risk of postoperative death (adjusted odds ratio, 5.92; 95% confidence interval, 3.69-9.52; P < .001) but not morbidity (adjusted odds ratio, 1.28; 95% confidence interval, 0.87-1.87; P = .21). CONCLUSIONS: Our study is the largest to date to describe the outcomes of patients with advanced malignancy who undergo surgical revascularization for arterial thromboembolism of the lower extremities. Such patients suffer high rates of early postoperative mortality and morbidity, especially when emergency operation is required. Early involvement of palliative care specialists is warranted in these patients to ensure that the decision to pursue surgical revascularization is aligned with their goals of care.

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Published In

J Vasc Surg

DOI

EISSN

1097-6809

Publication Date

October 2014

Volume

60

Issue

4

Start / End Page

987 / 992

Location

United States

Related Subject Headings

  • Vascular Surgical Procedures
  • United States
  • Treatment Outcome
  • Time Factors
  • Thromboembolism
  • Survival Rate
  • Risk Assessment
  • Retrospective Studies
  • Postoperative Period
  • Peripheral Arterial Disease
 

Citation

APA
Chicago
ICMJE
MLA
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Bennett, K. M., Scarborough, J. E., Shortell, C. K., & Cox, M. W. (2014). Outcomes of surgical revascularization for lower extremity arterial thromboembolism in patients with advanced malignancy. J Vasc Surg, 60(4), 987–992. https://doi.org/10.1016/j.jvs.2014.04.064
Bennett, Kyla M., John E. Scarborough, Cynthia K. Shortell, and Mitchell W. Cox. “Outcomes of surgical revascularization for lower extremity arterial thromboembolism in patients with advanced malignancy.J Vasc Surg 60, no. 4 (October 2014): 987–92. https://doi.org/10.1016/j.jvs.2014.04.064.
Bennett KM, Scarborough JE, Shortell CK, Cox MW. Outcomes of surgical revascularization for lower extremity arterial thromboembolism in patients with advanced malignancy. J Vasc Surg. 2014 Oct;60(4):987–92.
Bennett, Kyla M., et al. “Outcomes of surgical revascularization for lower extremity arterial thromboembolism in patients with advanced malignancy.J Vasc Surg, vol. 60, no. 4, Oct. 2014, pp. 987–92. Pubmed, doi:10.1016/j.jvs.2014.04.064.
Bennett KM, Scarborough JE, Shortell CK, Cox MW. Outcomes of surgical revascularization for lower extremity arterial thromboembolism in patients with advanced malignancy. J Vasc Surg. 2014 Oct;60(4):987–992.
Journal cover image

Published In

J Vasc Surg

DOI

EISSN

1097-6809

Publication Date

October 2014

Volume

60

Issue

4

Start / End Page

987 / 992

Location

United States

Related Subject Headings

  • Vascular Surgical Procedures
  • United States
  • Treatment Outcome
  • Time Factors
  • Thromboembolism
  • Survival Rate
  • Risk Assessment
  • Retrospective Studies
  • Postoperative Period
  • Peripheral Arterial Disease