Eanas Yassa, Francis J. Caputo, Jose Trani, Krystal Hunter, James Alexander, Jeffrey P. Carpenter, Joseph V. Lombardi
Vascular Surgery, Cooper University Hospital, Camden, NJ.
OBJECTIVES: Prior studies have identified gender as having significant impact on the outcome after vascular surgery. We sought to determine the role of gender on patient outcomes after aortoiliac reconstruction.
METHODS: Patients in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) participant use file that underwent AI reconstruction, whether open or endovascular, between July 1, 2011, and June 30, 2012 were identified by CPT codes. Preoperative risk factors, intra-operative variables and outcomes were compared across genders and were statistically analyzed. Thirty-day mortality was assessed.
RESULTS: During the study period, there were a total of 1,598 patients who underwent aortoiliac reconstruction, with 1,091 open reconstructions and 507 endovascular reconstructions. Of the 1,091 open reconstructions, 476 were performed on females (44%) vs. 615 performed on males (56%).The mortality rates were 3.4% vs. 0.81% respectively (p<0.05). Compared to females alive, females who died were more likely to have a longer pre and post-op hospital length of stay, increased age (mean age 65.8 vs. mean age 74.5, p<0.05), a CHF exacerbation in last 30 days, higher incidence of postoperative renal failure (12.5% vs. 0.4%, p<0.05), and a higher incidence of transfusion (50% vs 10%, p<0.05). There were 507 endovascular reconstructions, where 218 were performed on females (43%) vs. 289 performed on males (57%). Mortality rates were 3.81% vs. 1.14% respectively (p<0.05). Compared to females alive, females who died were older (mean age 70.5 vs. mean age 60.8, p<0.05 ), more likely to have an unplanned return to OR (63% vs. 12%, p<0.05) and more likely to require blood transfusion (18% vs. 0.01%, p<0.05). Comparison between males and females who died did not reveal statistically significant causative risk factors.
CONCLUSIONS: ACS NSQIP data suggests that gender is an independent risk-factor in 30-day mortality in patients undergoing either open or endovascular aortoiliac reconstructions.
AUTHOR DISCLOSURES: J. Alexander: Nothing to disclose; F. J. Caputo: Nothing to disclose; J. P. Carpenter: Nothing to disclose; K. Hunter: Nothing to disclose; J. V. Lombardi: Nothing to disclose; J. Trani: Nothing to disclose; E. Yassa: Nothing to disclose.
Posted April 2013