Peripheral vascular disease and outcomes following coronary artery bypass graft surgery.
OBJECTIVE
There is an increased operative risk in patients with a history of peripheral vascular disease (PVD) who undergo coronary artery bypass grafting (CABG). There are also outcome differences associated with these patients.


METHODS
A study from a 10-year hospitalization cohort with prospective data collection.


METHODS
Multiple hospitals in the Greater Cincinnati area with 1 surgical group of cardiac surgeons.


METHODS
Cases were CABG patients with PVD, which was defined as having a history of type 1 neurologic injury, prior vascular surgery, or current vascular disease (n = 1561). Controls were CABG patients without PVD (n = 6328).


METHODS
The study examined 42 potential confounding risk factors and 16 outcome variables.


RESULTS
Twenty-nine potential risk factors were found to be significantly different between CABG patients with and without PVD. Twenty-six confounding risk factors were correlated with 3 factors. Logistic regression analysis showed that even after controlling for sex, significant associative disorders, and other procedures, CABG patients with PVD still experienced more arrhythmias requiring treatment (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.03-1.33; P = .01), neurological complications (OR, 1.7; 95% CI, 1.43-2.07; P<.001), pulmonary complications (OR, 1.4; 95% CI, 1.23-1.62; P<.001), low output (OR, 1.3; 95% CI, 1.09-1.45; P = .001), and intraoperative complications (OR, 1.39; 95% CI, 1.06-1.83; P = .02).


CONCLUSIONS
Patients with a PVD history undergoing CABG had more coexistent risk factors. These patients also exhibited higher rates of cardiac, systemic, renal, neurologic, and pulmonary complications.
Collison
Ted
T
Department of Surgery, Good Samaritan Hospital, 375 Dixmyth Avenue, Cincinnati, OH 45220, USA.
Smith
J Michael
JM
Engel
Amy M
AM
D000368:Aged; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology*; D016896:Treatment Outcome