BACKGROUND: The European system for cardiac operative risk evaluation, the most popular European scoring system in cardiac surgery, uses the extracardiac arteriopathy as a risk factor for early mortality. We studied the effect of peripheral vascular disease (PVD) on early and late mortality in a large group of patients undergoing isolated coronary artery bypass surgery (CABG) surgery. METHODS: During a ten-year period (January 1998 through December 2007) 10,626 patients underwent isolated CABG in our hospital. The primary endpoints of this study were early and late all-cause mortality. For each year of the study period, general population cohorts were matched with the patient groups for age and gender (expected survival). RESULTS: Out of 10,504 patients included in the analysis, 1,222 (11.63%) patients had PVD. The PVD was identified as an independent risk factor for late mortality (death at any time after hospital discharge) (hazard ratio of 1.67 [1.43 to 1.95], p < 0.0001), but not for early mortality (death within 30 days or before discharge) (hazard ratio of 1.06 [0.70 to 1.60], p = 0.776). Patients without PVD had a better survival than patients with PVD (log-rank p < 0.0001) and even a better survival compared to the normal Dutch population survival (p value < 0.002). The PVD patients had a worse than expected survival (log-rank p < 0.0001). CONCLUSIONS: Peripheral vascular disease is an independent risk factor only for late mortality but not for early mortality. Compared with age-matched and sex-matched cohorts from the general Dutch population, the ten-year survival of patients with peripheral vascular disease was worse; whereas the survival of patients with no peripheral vascular disease was better. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
BACKGROUND: The European system for cardiac operative risk evaluation, the most popular European scoring system in cardiac surgery, uses the extracardiac arteriopathy as a risk factor for early mortality. We studied the effect of peripheral vascular disease (PVD) on early and late mortality in a large group of patients undergoing isolated coronary artery bypass surgery (CABG) surgery. METHODS: During a ten-year period (January 1998 through December 2007) 10,626 patients underwent isolated CABG in our hospital. The primary endpoints of this study were early and late all-cause mortality. For each year of the study period, general population cohorts were matched with the patient groups for age and gender (expected survival). RESULTS: Out of 10,504 patients included in the analysis, 1,222 (11.63%) patients had PVD. The PVD was identified as an independent risk factor for late mortality (death at any time after hospital discharge) (hazard ratio of 1.67 [1.43 to 1.95], p < 0.0001), but not for early mortality (death within 30 days or before discharge) (hazard ratio of 1.06 [0.70 to 1.60], p = 0.776). Patients without PVD had a better survival than patients with PVD (log-rank p < 0.0001) and even a better survival compared to the normal Dutch population survival (p value < 0.002). The PVD patients had a worse than expected survival (log-rank p < 0.0001). CONCLUSIONS:Peripheral vascular disease is an independent risk factor only for late mortality but not for early mortality. Compared with age-matched and sex-matched cohorts from the general Dutch population, the ten-year survival of patients with peripheral vascular disease was worse; whereas the survival of patients with no peripheral vascular disease was better. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Authors: Ralf E Harskamp; John H Alexander; Phillip J Schulte; W Schuyler Jones; Judson B Williams; Michael J Mack; Eric D Peterson; C Michael Gibson; Robert M Califf; Nicholas T Kouchoukos; T Bruce Ferguson; Robbert J de Winter; Renato D Lopes Journal: Ann Thorac Surg Date: 2013-12-21 Impact factor: 4.330