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

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  • 1 Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.
  • | 2 Delaware Country Memorial Hospital Center for Wound Healing, Havertown, PA.
  • | 3 Department of Vascular Surgery, Temple University Hospital, Philadelphia, PA.

Abstract

Background: The objective of this investigation was to evaluate adverse short-term outcomes following open lower extremity bypass surgery in subjects with diabetes mellitus with a specific comparison performed based on subject height.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was analyzed to select those subjects with CPT codes 35533, 35540, 35556, 35558, 35565, 35566, 35570 and 35571 and with the diagnosis of diabetes mellitus. This resulted in 83 subjects ≤60 inches, 1084 subjects >60 inches and <72 inches, and 211 subjects ≥72 inches.

Results: No differences were observed between groups with respect to the development of a superficial surgical site infection (9.6% vs. vs. 6.4% vs. 5.7%; p=0.458), deep incisional infection (1.2% vs. 1.4% vs. 2.8%; p=0.289), sepsis (2.4% vs. 2.0% vs. 2.8%; p=0.751), unplanned reoperation (19.3% vs. 15.6% vs. 21.8%; p=0.071), nor unplanned hospital readmission (19.3% vs. 14.8% vs. 17.1%; p=0.573). A significant difference was observed between groups with respect to the development of a wound disruption (4.8% vs. 1.3% vs. 4.7%; p=0.001). A multivariate regression analysis was performed of the wound disruption outcome with the age, gender, race, ethnicity, height, weight, current smoker and open wound/wound infection variables. Race (p=0.025) and weight (p=0.003) were found to be independently associated with wound disruption, but height was not (p=0.701).

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

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