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International Angiology 2021 Mar 19

DOI: 10.23736/S0392-9590.21.04642-3


lingua: Inglese

The abdominal waist circumference and 4 year outcomes following peripheral bypass grafting

Mohammed A. WADUUD 1 , Penelope P. SUCHARITKUL 1, Marilena GIANNOUDI 2, Marc A. BAILEY 1, David J. SCOTT 2

1 Leeds Institute for Cardiovascular and Metabolic Medicine, Level 7 LIGHT Laboratories, University of Leeds, Leeds, UK; 2 Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK


BACKGROUND: Current literature evaluating the relationship between obesity, utilising measures other than the body mass index (BMI), and post-operative outcomes following vascular surgery are sparse. This study aimed to investigate any association between abdominal waist circumference (AWC) and waist-hip ratio (WHR) in relation to post-operative morbidity and mortality following peripheral artery bypass graft (PABG) surgery.
METHODS: AWC and hip circumference (HC) were measured from pre-intervention magnetic resonance (MR) and computed tomography (CT) scans of patients undergoing elective and non-elective PABG. The AWC and WHR were assessed in relation to: the need for higher level care (i.e. level 2/3), duration of higher level care, post-operative limb ischaemia, post-operative hospital stay, graft patency on discharge and 30 day readmission, using logistic and linear regression analysis. Mortality was assessed using cox-regression analysis with calculation of hazard ratios at 30 days and 4 years.
RESULTS: In total, 177 patient images performed between January 2014 to January 2017 were analysed. There were no significant intra-observer and inter-observer differences in measurements of AWC and HC. Pre-intervention AWC was predictive of the need for higher level care following non-elective PABG (adjusted OR 1.1 (95%CI 1.0-1.1, p=0.026). An inverse relationship between AWC and mortality at 4 years was also observed (adjusted HR 0.9, 95%CI 0.9-1.0, p=0.028). Pre-intervention WHR, however, failed to predict mortality and morbidity.
CONCLUSIONS: AWC may potentially be a suitable risk stratification tool in patients undergoing non-elective PABG. The association of AWC with long-term mortality outcomes require further investigation so that suitable cut-off values may be determined.

KEY WORDS: Peripheral vascular disease; Adiposity; Obesity; Risk stratification; Surgery

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