Journal article
Regional anesthesia is associated with improved mortality and morbidity in patients with congestive heart failure undergoing lower extremity amputation
Annals of vascular surgery, Vol.108, pp.206-211
06/29/2024
DOI: 10.1016/j.avsg.2024.04.019
PMID: 38950851
Abstract
While existing literature reports variable results of general anesthesia (GA) and regional anesthesia (RA) in patients undergoing lower extremity amputation (LEA), the effect of RA on patients with congestive heart failure (CHF) has not been explored. This study aims to assess whether the choice of anesthesia plays a role in influencing outcomes within this vulnerable population.
Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) files between 2005-2022, all patients receiving LEA were identified, and the subset of patients with CHF was included. Patient characteristics and 30-day outcomes were compared using χ2 or Fischer’s exact test as appropriate for categorical variables and the independent t-test or Mann-Whitney U test as appropriate for continuous variables. The association between anesthesia modality and post-operative outcomes was studied using multivariable logistic regression analysis.
A total of 5,831 patients (4,779 undergoing GA, 1,052 undergoing RA) with a diagnosis of CHF undergoing LEA were identified. On multivariable logistic regression analysis, RA was associated with lower mortality (aOR 0.79, 95% CI 0.65-0.97), pneumonia (aOR 0.76, 95% CI 0.58-0.99), septic shock (aOR 0.64, 95% CI 0.47-0.88), post-operative blood transfusion (aOR 0.82, 95% CI 0.70-0.97), and 30-day readmission (aOR 0.79, 95% CI 0.64-0.97).
This study demonstrates that RA for LEA in patients with CHF is associated with decreased morbidity and mortality compared to GA. While further research is needed to confirm this association, RA should be at least considered in CHF patients undergoing LEA when feasible.
Details
- Title: Subtitle
- Regional anesthesia is associated with improved mortality and morbidity in patients with congestive heart failure undergoing lower extremity amputation
- Creators
- Mohamad Chahrour - University of IowaHassan Chamseddine - University of Iowa Hospitals and ClinicsLoay Kabbani - Henry Ford HospitalMaen Aboul Hosn - Division of Vascular Surgery, Department of Surgery, University of Iowa Hospital and Clinics, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Annals of vascular surgery, Vol.108, pp.206-211
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.avsg.2024.04.019
- PMID
- 38950851
- ISSN
- 0890-5096
- eISSN
- 1615-5947
- Language
- English
- Electronic publication date
- 06/29/2024
- Academic Unit
- Surgery
- Record Identifier
- 9984652260102771
Metrics
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