Cardiovascular-Specific Mortality and @entity8 in XXXX Undergoing Vascular Surgery.

@entity1 @entity8 @entity5 @entity740 @entity810 @entity204 @entity65
Importance: @entity810 ( @entity810 ) affects as many as 40% of @entity1 undergoing surgery and is associated with increased all-cause mortality. @entity740 ( @entity740 ) is a well-known risk factor for cardiovascular mortality. Objective: To determine the association between @entity8 and long-term cardiovascular-specific mortality after vascular surgery. Design, Setting, and @entity1 : A single-center cohort of 3646 @entity1 underwent inpatient vascular surgery from January 1, 2000, to November 30, 2010, at a tertiary care teaching hospital. To determine cause-specific mortality for @entity1 undergoing vascular surgery, a proportional subdistribution hazards regression analysis was used to model long-term cardiovascular-specific mortality while treating any other cause of @entity204 as a competing risk. @entity8 constituted the main covariate after adjusting for baseline @entity1 characteristics, surgery type, and admission hemoglobin level. Final follow-up was completed July 2014 to assess survival through January 31, 2014, and data were analyzed from June 1, 2014, to September 7, 2015. Main Outcomes and Measures: Perioperative @entity810 , presence of @entity740 , and overall and cause-specific mortality. Results: Among the 3646 @entity1 undergoing vascular surgery, perioperative @entity810 occurred in 1801 (49.4%) and @entity740 was present in 496 (13.6%). The top 2 causes among the 1577 @entity204 in our cohort were @entity65 (845 of 1577 [53.6%]) and @entity5 (173 of 1577 [11.0%]). Adjusted cardiovascular mortality estimates at 10 years were 17%, 31%, 30%, and 41%, respectively, for @entity1 with no @entity8 , @entity810 without @entity740 , @entity740 without @entity810 , and @entity810 with @entity740 . Adjusted hazard ratios (95% CIs) for cardiovascular mortality were significantly elevated among @entity1 with @entity810 without @entity740 (2.07 [1.74-2.45]), @entity740 without @entity810 (2.01 [1.46-2.78]), and @entity810 with @entity740 (2.99 [2.37-3.78]) and were higher than those for other risk factors, including increasing age (1.03 per 1-year increase; 1.02-1.04), emergent surgery (1.47; 1.27-1.71), and admission hemoglobin levels lower than 10 g/dL (1.39; 1.14-1.69) compared with a hemoglobin level of 12 g/dL or higher. Conclusions and Relevance: Perioperative @entity810 is common in @entity1 undergoing vascular surgery and is associated with a high risk for cardiovascular-specific mortality comparable to that seen with @entity740 . These findings reinforce the importance of preoperative and postoperative risk stratification for @entity8 and the implementation of strategies now available to help prevent perioperative @entity810 .
