Effect of diabetes mellitus on the clinical outcome of lower limb arterial bypass surgery: A propensity score analysis. (August 2017)

• Record Type: Journal Article
• Authors: Lazaris, Andreas M; Kontopantelis, Evangelos; Antonopoulos, Konstantinos; Mantas, Georgios; Kouvelos, Georgios; Moulakakis, Konstantinos; Matsagkas, Miltiadis I; Vasdekis, Spyros N; Geroulakos, George
• Is Part Of: Vascular. Volume 25:Number 4(2017)
• Page Start: 364
• Page End: 371
• Publication Date: 2017-08
• Subjects: Diabetes mellitus -- lower limb bypass surgery -- propensity score analysis; 616.13
• DOI: 10.1177/1708538116682911
• Languages: English
• ISSNs: 1708-5381

Abstract

Objectives: Diabetic patients who undergo lower limb arterial bypass surgery are considered to have a worse clinical outcome compared to non-diabetics. The aim of the study was to test this hypothesis after applying propensity score matching analysis. Patients and methods: A total of 113 consecutive lower limb bypass procedures (55 diabetic and 58 non-diabetic) were evaluated regarding their clinical outcome. Endpoints of the study included amputation-free survival, limb salvage, patency and patients' survival up to 36 months post-procedure. After propensity score matching analysis, two new groups, diabetic and non-diabetic, of 31 limbs in each one were created, both equivalent regarding all baseline characteristics. Results: Between the propensity score matching groups, the amputation-free survival was 68.8% in the non-diabetic and 37.7% in the diabetic group at 36 months ( p = 0.004). Similarly, the survival was 88.6% and 57.6%, respectively, in the two groups at the same time point ( p = 0.01). On the contrary, no difference was found in patency (58.3% vs. 56%) and in limb salvage rate (74.1% vs. 60.8%). Conclusions: Lower limbs arterial bypass surgery has similar results regarding patency and limb salvage rate in diabetic and non-diabetic patients. On the contrary, mortality is worse in diabetic patients, this affecting negatively their amputation-free survival.