RESUMO
BACKGROUND: An increased operative time (OT) has been associated with a higher rate of adverse outcomes after several surgical procedures although scarce evidence exists for infrainguinal bypass surgery (IBS) and its impact beyond the postoperative period. The aim of this study was to define surgical characteristics related to a prolonged OT in IBS for chronic limb threatening ischemia and its influence on postoperative and 1-year outcomes. MATERIALS AND METHODS: Retrospective study of 249 consecutive patients (mean age 72.4 years, 73.1% male) undergoing IBS for CLI between 2008 and 2018. The characteristics related to the duration of surgery and its impact on outcome were assessed with a multiple linear regression and a multivariate logistic regression, respectively. RESULTS: Interventions associated with a prolonged OT included the bypass to a below-the-knee artery (additional 36 min, p = 0.002), the need for an alternative vein or a hybrid PTFE-vein graft (additional 37 min, p = 0.02) and inflow associated procedures (additional 47 min, p < 0.001). OT was associated with a higher rate of postoperative complications (OR for each additional 30 min 1.123, 95% CI 1.021-1.234) and need for a sociosanitary facility at discharge (OR 1.143, 95% CI 1.033-1.265). At 1-year of follow-up, OT was related to a higher major amputation rate (OR 1.201, 95% CI 1.036-1.393) and non-significantly to mortality (OR 1.125, 95% CI 0.999-1.268). CONCLUSIONS: A prolonged OT is a risk factor for adverse outcomes after IBS that extends beyond the immediate postoperative period. Further research is needed to evaluate how an expected high OT might influence decision-making.
Assuntos
Isquemia , Salvamento de Membro , Idoso , Amputação Cirúrgica , Feminino , Humanos , Isquemia/cirurgia , Extremidade Inferior/cirurgia , Masculino , Duração da Cirurgia , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoAssuntos
Artérias Carótidas , Estenose das Carótidas , Humanos , Constrição Patológica , Estenose das Carótidas/complicações , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/cirurgia , Ultrassonografia Doppler Dupla , Velocidade do Fluxo Sanguíneo , Artéria Carótida Interna/diagnóstico por imagem , Sensibilidade e EspecificidadeAssuntos
Sistemas Computadorizados de Registros Médicos , Software , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
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