Differential effect of nutritional status on vascular surgery outcomes in a Veterans Affairs versus private hospital setting

Laura T. Boitano, Edward C. Wang, Melina R. Kibbe*

*Corresponding author for this work

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Background: The goal of this study was to determine whether preoperative albumin level in vascular surgery patients is predictive of postoperative outcomes in the Veterans Affairs (VA) versus private sector and in open versus endovascular interventions. Methods: A retrospective analysis of male patients with peripheral arterial disease, carotid artery disease, and abdominal aortic aneurysms who underwent open or endovascular interventions at the Jesse Brown VA Medical Center or Northwestern Memorial Hospital from January 2006 to June 2009 was conducted. Preoperative demographics and postoperative outcomes were assessed. Major adverse events (MAE) were defined as myocardial infarction, stroke, or death. Results: A total of 591 men were included. Preoperative albumin level was significantly higher in VA versus private sector patients (3.6 ±.5 g/dL vs 3.2 ±.8 g/dL, respectively; P =.0001) and endovascular versus open patients (3.6 ±.6 g/dL vs 3.3 ±.7 g/dL, respectively; P <.0001). Albumin level was an independent predictor of MAE (odds ratio [OR],.46; P =.04) and 1-year death (OR,.35; P =.01) for all patients, and was predictive of MAE (OR,.40; P =.05) and 1-year death (OR,.23; P =.0008) in the open cohort. Conclusions: Preoperative malnutrition has important prognostic implications for vascular surgery patients in both the VA and private hospital settings, especially for those patients undergoing open repair.

Original languageEnglish (US)
Pages (from-to)e27-e37
JournalAmerican journal of surgery
Volume204
Issue number5
DOIs
StatePublished - Nov 1 2012

Keywords

  • Albumin
  • Complications
  • Postoperative outcomes
  • Vascular surgery

ASJC Scopus subject areas

  • Surgery

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