دورية أكاديمية
Clinical Implications of Low Body Mass Index on Endovascular Lower Extremity Revascularization.
| العنوان: | Clinical Implications of Low Body Mass Index on Endovascular Lower Extremity Revascularization. |
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| المؤلفون: | Pinto Rodriguez P; Division of Vascular Surgery and Endovascular Therapy, Yale University School of Medicine, New Haven, CT. Electronic address: paula.pintorodriguez@yale.edu., Alameddine D; Division of Vascular Surgery and Endovascular Therapy, Yale University School of Medicine, New Haven, CT., Huttler J; Yale University School of Medicine, New Haven, CT., Damara FA; Division of Vascular Surgery and Endovascular Therapy, Yale University School of Medicine, New Haven, CT., Slade M; Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, CT, USA., Cardella J; Division of Vascular Surgery and Endovascular Therapy, Yale University School of Medicine, New Haven, CT., Guzman RJ; Division of Vascular Surgery and Endovascular Therapy, Yale University School of Medicine, New Haven, CT., Chaar CIO; Division of Vascular Surgery and Endovascular Therapy, Yale University School of Medicine, New Haven, CT. |
| المصدر: | Annals of vascular surgery [Ann Vasc Surg] 2024 Sep; Vol. 106, pp. 350-359. Date of Electronic Publication: 2024 May 28. |
| نوع المنشور: | Journal Article; Comparative Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8703941 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1615-5947 (Electronic) Linking ISSN: 08905096 NLM ISO Abbreviation: Ann Vasc Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2007->: Netherlands : Elsevier Original Publication: Detroit : [Published by Expansion scientifique française for Annals of Vascular Surgery, Inc. and Association pour la promotion de la chirurgie vasculaire, Paris, c1986- |
| مواضيع طبية MeSH: | Peripheral Arterial Disease*/mortality , Peripheral Arterial Disease*/diagnosis , Peripheral Arterial Disease*/surgery , Body Mass Index* , Endovascular Procedures*/adverse effects , Endovascular Procedures*/mortality , Thinness*/mortality , Thinness*/complications , Thinness*/diagnosis , Databases, Factual* , Lower Extremity*/blood supply, Humans ; Female ; Male ; Retrospective Studies ; Aged ; Risk Factors ; Time Factors ; Middle Aged ; Risk Assessment ; Limb Salvage ; Amputation, Surgical ; Aged, 80 and over ; Treatment Outcome ; United States/epidemiology ; Progression-Free Survival ; Obesity/complications ; Postoperative Complications/etiology ; Postoperative Complications/mortality |
| مستخلص: | Background: The epidemic of obesity and associated cardiovascular morbidity continues to grow, attracting public attention and healthcare resources. However, the impact of malnutrition and being underweight continues to be overshadowed by obesity, especially in patients with peripheral arterial disease (PAD). This study assesses the characteristics and outcomes of patients with low body mass index (BMI ≤ 18.5) compared to patients with nonobese BMI undergoing peripheral vascular interventions (PVI). Methods: A retrospective analysis of patients undergoing PVI due to PAD registered in the Vascular Quality Initiative database. Patients were categorized into underweight (BMI ≤ 18.5) and nonobese BMI (BMI = 18.5-30). Patients in both groups were matched 3:1 for baseline demographic characteristics, comorbidities, medications, and indications. Kaplan-Meier analysis was done for long-term outcomes. Results: A total of 337,926 patients underwent PVI, of whom 12,935 (4%) were underweight, 215,728 (64%) were nonobese, and 109,263 (32%) were obese. Underweight patients were more likely to be older, female, smokers, with chronic obstructive pulmonary disorder, and more likely to present with chronic limb-threatening ischemia than nonobese patients. After propensity matching, there were 18,047 nonobese patients and 6,031 underweight patients. There were no significant differences in matched characteristics. Perioperatively, underweight patients were more likely to require a longer hospital length of stay. Underweight patients had statistically significantly higher 30-day mortality compared to patients with nonobese BMI (3% vs. 1.6%, P < 0.001) and a higher rate of thrombotic complications. As for long-term outcomes, underweight patients had a higher rate of reintervention (20% vs. 18%, P < 0.001) and major adverse limb events (27% vs. 22%, P < 0.001). The 4-year rate of amputation-free survival was significantly lower in underweight patients (70% vs. 82%, P < 0.001), and the 2-year freedom from major amputation (90% vs. 94%, P < 0.001) showed similar trends with worse outcomes in patients who were underweight. Conclusions: Underweight patients with PAD are disproportionally more likely to be African American, females, and smokers and suffer worse outcomes after PVI than PAD patients with nonobese BMI. When possible, increased scrutiny and optimization of nutrition and other factors contributing to low BMI should be addressed prior to PVI. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| تواريخ الأحداث: | Date Created: 20240529 Date Completed: 20240810 Latest Revision: 20240810 |
| رمز التحديث: | 20240812 |
| DOI: | 10.1016/j.avsg.2024.02.031 |
| PMID: | 38810726 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1615-5947 |
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| DOI: | 10.1016/j.avsg.2024.02.031 |