Assessment of the Risk Analysis Index for Prediction of Mortality, Major Complications, and Length of Stay in Patients who Underwent Vascular Surgery

Rothenberg, Kara A.; George, Elizabeth; Trickey, Amber W.; Barreto, Nicolas B.; Johnson, Theodore M.; Hall, Daniel E.; Johanning, Jason M.; Arya, Shipra

doi:10.1016/j.avsg.2020.01.015

Cited by 44 publications

(39 citation statements)

References 30 publications

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“…After applying the in-and exclusion criteria, 2,686 articles were excluded. Out of the remaining 41 full-texts, 27 studies were excluded because of using a single-domain frailty tool, and six for miscellaneous reasons (i.e., full-text not accessible or no primary data presented), resulting in eight articles that were included in this systematic review (20)(21)(22)(23)(24)(25)(26)(27).…”

Section: Resultsmentioning

confidence: 99%

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Role of pre-operative frailty status in relation to outcome after carotid endarterectomy: a systematic review

Benjamens¹,

Bokkers²,

Zeebregts³

et al. 2021

Ann Transl Med

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Carotid endarterectomy (CEA) is a surgical treatment option to prevent ischemic cerebrovascular accidents. Patients that present with pre-operative frailty might have an elevated risk for unfavorable outcomes after the CEA. A systematic search, using Medline, Embase, Web of Science and Cochrane Database, was performed for relevant literature on frailty in patients undergoing CEA. The study protocol was registered with PROSPERO (CRD42020190345). Eight articles were included. The pooled prevalence for pre-operative frailty was 23.9% (95% CI: 12.98-34.82). A difference in the incidence of complications between frail and non-frail patients (6.4% vs. 5.2%, respectively) and a difference in hospital length of stay [2 (IQR: 2-3) days vs. 1 (IQR: 1-2) day, respectively] were described. The 30-day mortality after CEA was 0.6% for non-frail patients, 2.6% for frail patients, and 4.9% for very frail patients (P<0.001). For 3-year mortality, a >1.5-fold increased risk was found for frail patients (OR 1.7, 95% CI: 1.4-2.0) and a >2.5-fold increased risk for very frail patients (OR 2.6, 95% CI: 2.2-3.1). In conclusion, this review shows the impact of frailty on outcome after CEA. Pre-operative frailty assessment with a validated, multi-domain tool should be implemented in the clinical setting as it will provide information on post-operative surgical outcomes and mortality risk but also frailty trajectory and cognitive decline.

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Section: Resultsmentioning

confidence: 99%

“…After quality assessment, six studies were identified as having low risk of bias (22)(23)(24)(25)(26)(27) and two studies as having moderate risk of bias (20,21) (Table 1). All studies focused on pre-operative frailty status (Table 2).…”

Section: Study Characteristicsmentioning

confidence: 99%

Role of pre-operative frailty status in relation to outcome after carotid endarterectomy: a systematic review

Benjamens¹,

Bokkers²,

Zeebregts³

et al. 2021

Ann Transl Med

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“…For suprainguinal revascularizations, 30-day mortality was 13.9% for very frail patients, 10.0% for frail patients and 1.8% for non-frail patients. For infrainguinal revascularizations, 30-day mortality was 9.4% for very frail patients, 6.3% for frail patients and 1.1% for non-frail patients [ 79 ].…”

Section: Revascularization Treatmentmentioning

confidence: 99%

Chronic Lower Extremity Ischemia and Its Association with the Frailty Syndrome in Patients with Diabetes

Jakubiak

Pawlas

Cieślar

et al. 2020

IJERPH

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Diabetes mellitus is an important risk factor for the development of cardiovascular diseases. Peripheral arterial disease affecting lower limb arteries is one of the clinical manifestations of atherosclerosis. The frailty syndrome (Frailty) is a problem associated with diminution of physiological reserves. The ankle-brachial index is a commonly used tool for diagnosing peripheral arterial disease (PAD). The usefulness of the ankle-brachial index (ABI) is limited in people with diabetes because of calcification of the middle layer of arteries. In this population, toe-brachial index should be measured. Frailty may be associated with worse prognosis for patients undergoing revascularization. Amputation may be an important factor leading to the development of Frailty. The risk of amputation and the prognosis after revascularization may be modified by some medications and blood glucose levels. The purpose of this paper is to review the literature about the association between PAD, especially in patients living with diabetes and Frailty.

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“…In the process of CDT, no change or a weak change in the monitored D-dimer level often indicates the presence of an arteriosclerotic plaque-occluded artery in the patient. Therefore, it is necessary to improve the blood supply of the ischaemic extremity as soon as possible by combining CDT with percutaneous transluminal angiography (PTA)/stent implantation 36 , 37 rather than waiting for 3 days until the completion of CDT. There were 58 patients whose CDT process did not reach 3 days during the study period.…”

Section: Discussionmentioning

confidence: 99%

The plasma D-dimer trends and their value in acute lower limb ischemia patients treated by catheter directed thrombolysis

Liu

Xie

Zheng

et al. 2021

Sci Rep

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To investigate the change trends of plasma D-dimer during catheter-directed thrombolysis (CDT) in acute lower limb ischemia (ALI) patients and their clinical value. A retrospective review of patients with ALI who received CDT was carried out. The repeated measurements of plasma D-dimer were analyzed by generalized estimating equations (GEEs) and the change trends of D-dimer were analyzed by spline regression approach. A total of 150 patients were included. Among them, 3 days of CDT was ineffective in 41 cases, effective in 33 cases and markedly effective in 76 cases. The results of GEEs analysis showed that serum D-dimer changed significantly with time (time effect, P < 0.001). Serum D-dimer levels of patients with different treatment outcomes were different after treatment (group effect, P < 0.001), and serum D-dimer levels in these three groups showed different trends over time (group*time effect, P < 0.001). The different trends in serum D-dimer level with time after treatment in the three groups could be directly seen in the spline regression curve (P < 0.001). The plasma D-dimer changes regularly during CDT for ALI. We can predict the efficacy of CDT and guide adjustments of the therapeutic regimen according to the trend of D-dimer changes during thrombolysis.

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Assessment of the Risk Analysis Index for Prediction of Mortality, Major Complications, and Length of Stay in Patients who Underwent Vascular Surgery

Cited by 44 publications

References 30 publications

Role of pre-operative frailty status in relation to outcome after carotid endarterectomy: a systematic review

Role of pre-operative frailty status in relation to outcome after carotid endarterectomy: a systematic review

Chronic Lower Extremity Ischemia and Its Association with the Frailty Syndrome in Patients with Diabetes

The plasma D-dimer trends and their value in acute lower limb ischemia patients treated by catheter directed thrombolysis

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