Metabolic Syndrome is Associated with an Increased Risk of 30-Day Morbidity and Mortality after Lower Extremity Bypass Surgery

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Medicine and Health Sciences


Context. Metabolic syndrome (MetS) refers to the combination of abdominal obesity, hyperglycemia or insulin resistance, dyslipidemia, and hypertension. MetS has been associated with morbidity and mortality after a variety of surgeries and procedures, and is also associated with risk of peripheral artery disease.

Objective. To determine the association between MetS and 30-day morbidity and mortality after lower extremity open bypass surgeries. Secondarily, to measure the association between preoperative aspirin, statins, and beta blockade with 30-day morbidity and mortality after lower extremity open bypass surgeries.

Design. This retrospective study was conducted using the American College of Surgeon National Surgery Quality Improvement Program (ACS NSQIP) – Vascular Procedure targeted database collected between 2011 and 2015.

Setting. 10,053 patients receiving lower extremity bypass surgery were included in this analysis. ACS NSQIP randomly samples patients from participating hospitals nation-wide. All procedures were conducted in the inpatient setting.

Methods. The association of MetS and preoperative aspirin, statin, and beta blocker with 30-day perioperative outcomes was assessed using univariate and multiple regression techniques. MetS was defined using the modified metabolic syndrome criteria (mMetS): Diabetes, Hypertension, and BMI > 30 kg/m2.

Results. After adjusting for covariates, mMetS was significantly associated with Infection (OR: 1.76, 95% CI:1.49, 2.09), Renal Dysfunction (OR: 2.42, 95% CI: 1.59, 3.69), Days from Operation to Discharge (0.60 days, 95% CI: 0.31, 0.89), and MI (OR: 1.66, 95% CI: 1.23, 2.24). Beta Blockade significantly increased length of stay(Days: 0.33, 95% CI: 0.10, 0.56).

Conclusion. mMetS was associated with an increased risk of perioperative morbidity and mortality. Preoperative statins and aspirin were not associated with any change in risk of perioperative morbidity and mortality. Preoperative beta blockade was associated with an increase in the average length of stay, but otherwise was not associated with perioperative morbidity and mortality.


Copyright 2017 all authors

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