Key result
Higher pre-intervention abdominal waist circumference was inversely associated with 4-year mortality following peripheral artery bypass grafting (HR 0.9; 95% CI 0.9-1.0; P=0.028).
Why the study?
Data evaluating the relationship between non-BMI obesity measures and postoperative outcomes after vascular surgery are sparse.
Does abdominal waist circumference predict postoperative morbidity and mortality in patients undergoing peripheral artery bypass graft surgery?
Cohort (n=177)
Does abdominal waist circumference predict postoperative morbidity and mortality in patients undergoing peripheral artery bypass graft surgery?
Effect estimate: HR 0.9 (95% CI 0.9-1.0)
p-value: p=0.028
Abdominal waist circumference may serve as a useful risk stratification tool for predicting the need for higher level care and long-term mortality in patients undergoing non-elective peripheral artery bypass grafting.
Hypothesis-generating for waist circumference in bypass risk stratification; should not yet change practice or prompt prospective trials.
BACKGROUND: Current literature evaluating the relationship between obesity, utilizing measures other than the Body Mass Index (BMI), and postoperative 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 postoperative 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 nonelective PABG. The AWC and WHR were assessed in relation to: the need for higher level care (i.e. level 2/3), the duration of higher level care, postoperative limb ischemia, postoperative 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 analyzed. There were no significant intra-observer and interobserver 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). However, pre-intervention WHR 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.
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Waduud et al. (2021) conducted a cohort in Peripheral artery bypass graft (PABG) (n=177). Abdominal waist circumference (AWC) was evaluated on Mortality at 4 years (HR 0.9, 95% CI 0.9-1.0, p=0.028). Higher pre-intervention abdominal waist circumference was inversely associated with 4-year mortality following peripheral artery bypass grafting (HR 0.9; 95% CI 0.9-1.0; P=0.028).
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