Mortality following operations for lower extremity peripheral arterial disease

Background: We sought to identify risk factors associated with mortality following surgery for peripheral arterial disease (PAD). Methods: We evaluated the association between levels of control of atherosclerotic risk - factors and time to mortality following either lower extremity bypass surgery or lower extremity - amputation using Cox proportional hazards regression. Results: Among 796 patients with PAD (defined by an ankle-brachial index [ABI]. 0.9), 230 (28.9%) underwent an operation for PAD (136, lower-extremity bypasses; 111, lower-extremity amputations). Participants were followed for up to six years after their diagnosis of PAD. A total of 107 (46.5% of the 230) died during the period of follow-up. Factors associated with mortality following lower extremity bypass surgery included age 70 years and older hazard ratio [HR] 1.88; 95% confidence interval [CI]: 1.01-3.51) and of African American race (HR 1.94; 95% CI: 1.04-3.62). Renal insufficiency was significantly associated with mortality following lower extremity amputation (HR 2.19; 95% CI: 1.16-4.13). Conclusion: Our data provide information on preoperative risk variables to consider when assessing long-term mortality in persons with PAD who are undergoing surgery for PAD.