Impact of perioperative events on mortality after major vascular surgery in a veteran patient population

Background: The aim of this study was to characterize the impact of perioperative events on long-term mortality after major vascular surgery at a single institution. Methods: A retrospective analysis of patients undergoing major vascular surgery was performed. The primary end point was all-cause long-term mortality. Cox regression analyses were performed to identify predictors of this outcome. Results: A total of 1,182 procedures in 706 patients were identified, including endovascular or open aortic aneurysm repair, open repair of aortoiliac or infrainguinal occlusive disease, amputations, and carotid endarterectomy. Perioperative cardiac and respiratory complications occurred in 4.9% and 1.4% of operations, respectively. On multivariate Cox regression analysis, adjusting for patient factors and operation performed, perioperative cardiac (hazard ratio, 5.3; 95% confidence interval, 1.7-15.9) and respiratory complications (hazard ratio, 5.01; 95% confidence interval, 1.48-16.98) were significant predictors of long-term mortality. Conclusions: Although serious perioperative cardiac and respiratory events are infrequent, they have a significant impact on long-term mortality after major vascular surgery, even when adjusted for comorbidities and type of operation.