{Reference Type}: Journal Article
{Title}: Functional Status and Out-of-Hospital Outcomes in Different Types of Vascular Surgery Patients.
{Author}: von Meijenfeldt GCI;Rydingsward JE;van der Laan MJ;Zeebregts CJ;Christopher KB;
{Journal}: Ann Vasc Surg
{Volume}: 75
{Issue}: 0
{Year}: Aug 2021
{Factor}: 1.607
{DOI}: 10.1016/j.avsg.2021.02.049
{Abstract}: <B>BACKGROUND: </B>We aimed to determine the correlation between the functional status at discharge in non-cardiac vascular surgery patients and the out-of-hospital mortality.<BR><B>METHODS: </B>We performed a retrospective cohort study including adult non-cardiac vascular surgery patients (open, endovascular and venous procedures) surviving hospitalization in Boston, Massachusetts, USA. The exposure of interest was functional status determined by a licensed physical therapist at hospital discharge and rated based on qualitative categories adapted from the Functional Independence Measure. The primary outcome was all cause 90-day mortality after hospital discharge. The secondary outcome was readmission within 30days. Adjusted odds ratios were estimated by multivariable logistic regression models.<BR><B>RESULTS: </B>This cohort included 2318 patients (male 51%; mean age 61 ± 17.7). After evaluation by a physiotherapist, 425 patients scored the lowest functional status, 631 scored moderately low, 681 moderately high and 581 scored the highest functional status. The lowest functional status was associated with a 3.41-fold increased adjusted odds for 90-day mortality (95%CI, 1.70-6.84) compared to patients with the highest functional status. When excluding venous intervention patients, the adjusted odds ratio was 6.76 (95%CI, 2.53-18.12) for the 90-day mortality post-discharge. The adjusted odds for readmission within 30-days was 1.5-fold increase in patients with the lowest functional status (95%CI, 1.04-2.20).<BR><B>CONCLUSIONS: </B>In vascular surgery patients surviving hospitalization, functional status is strongly associated with out-of-hospital mortality and readmission rate. Future trials could provide evidence if improvement of functional status could prevent adverse outcomes in the postoperative setting.