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The Effect of Height on Adverse Short-Term Outcomes After Lower-Extremity Bypass Surgery in Patients with Diabetes Mellitus

Kushkaran Kaur Temple University Hospital Podiatric Surgical Residency Program, Philadelphia, PA.

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Rhonda S. Cornell Foot Care Center, Havertown, PA.

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Lawrence Oresanya Department of Vascular Surgery, Temple University Hospital, Philadelphia, PA.

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Andrew J. Meyr Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Background: We evaluated adverse short-term outcomes after open lower-extremity bypass surgery in patients with diabetes mellitus with a comparison performed based on patient height.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was analyzed to select patients with Current Procedural Terminology codes 35533, 35540, 35556, 35558, 35565, 35566, 35570, and 35571 and with the diagnosis of diabetes mellitus. This resulted in 83 patients 60 inches or less in height, 1,084 between 60 and 72 inches, and 211 patients 72 inches and taller.

Results: No differences were observed among groups with respect to the development of a superficial surgical site infection (9.6% versus 6.4% versus 5.7%; P = .458), deep incisional infection (1.2% versus 1.4% versus 2.8%; P = .289), sepsis (2.4% versus 2.0% versus 2.8%; P = .751), unplanned reoperation (19.3% versus 15.6% versus 21.8%; P = .071), or unplanned hospital readmission (19.3% versus 14.8% versus 17.1%; P = .573). A significant difference was observed among groups in the development of a wound disruption (4.8% versus 1.3% versus 4.7%; P = .001). A multivariate regression analysis was performed of the wound disruption outcome with the variables of age, sex, race, ethnicity, height, weight, current smoker, and open wound/wound infection. Race (P = .025) and weight (P = .003) were found to be independently associated with wound disruption, but height was not (P = .701).

Conclusions: The results of this investigation demonstrate no significant differences in short-term adverse outcomes after lower-extremity bypass surgery based on patient height.

Corresponding author: Andy J. Meyr, DPM, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, 148 N 8th St, Philadelphia, PA 19107. (E-mail: ajmeyr@gmail.com)
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