BACKGROUND: Despite increased awareness of the value of discussing @entity1 ' goals of care, advance directives, and code status as part of the surgical informed consent process, the actual outcomes and risks of cardiopulmonary resuscitation (CPR) remain poorly defined among some subsets of surgical @entity1 . Thus, in an effort to generate an evidence base for communication about shared decision making and informed consent for vascular surgery @entity1 and their surrogates, we defined the incidence, risks, and outcomes of postoperative @entity1167 after primary vascular surgery procedures. METHODS: The 2007 to 2010 National Surgical Quality Improvement Program data were queried to develop a multi-institutional database of @entity1 undergoing vascular surgery (N  = 123,581). Univariate analyses and multivariate logistic regression were used to identify crude and adjusted risk factors for postoperative @entity1167 requiring CPR and to assess outcomes. RESULTS: Postoperative @entity1167 requiring CPR was seen in 1234 of 123,581 @entity1 (1.0%) after vascular surgery at a  mean of 7.2     2  days. The 30-day mortality was 73.4% compared with 2.7% among @entity1 who did not arrest (P  <  .001). Of CPR survivors, 102 (12.1%) were still hospitalized at 30  days. @entity1 variables that were most predictive of postoperative @entity1167 included dependent functional status (odds ratio [OR], 2.9; 95% confidence interval [CI], 2.3-3.6; P  < .001), dialysis @entity734 (OR, 2.7; 95% CI, 2.3-3.2; P  < .001), emergent case (OR, 2.2; 95% CI, 1.9-2.5; P  < .001), and preoperative @entity734 (OR, 2.0; 95% CI, 1.5-2.7; P  < .001). Procedures associated with the highest risk included thoracic aortic surgery (OR, 6.9; 95% CI, 4.8-9.9; P  < .001), open abdominal procedures (OR, 3.7; 95% CI, 3.1-4.4; P  < .001), axillary-femoral bypass (OR, 2.1; 95% CI, 1.3-3.2; P  = .001), and @entity1897 (OR, 1.5; 95% CI, 1.2-1.9; P  = .002). At least one major complication preceded @entity1167 in 47.7% of @entity1 including @entity295 (23.5%), @entity177 (14.5%), and @entity583 (12.1%). @entity1 with do not resuscitate orders were significantly less likely to undergo CPR (OR, 0.59; 95% CI, 0.39-0.93; P  = .021). CONCLUSIONS: @entity1 undergoing vascular surgery who suffer a postoperative @entity1167 frequently die in spite of receiving CPR; for those who survive, there is likely to be prolonged hospitalization and significant morbidity. These data provide an evidence base for discussing goals of care, advance directives, and code status with vascular surgery @entity1 and their surrogates. Further research into how to best communicate risk, to elicit @entity1 preferences, and to engage in shared decision making is needed.

Outcomes and risk factors of XXXX after vascular surgery procedures.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'Patient'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure'] @entity1897 :: ('MESH:D010523', 'Disease') :: ['peripheral embolectomy'] @entity1167 :: ('MESH:D006323', 'Disease') :: ['cardiac arrest'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity734 :: ('MESH:D019966', 'Disease') :: ['dependence', 'ventilator dependence']
@entity1167 :: (MESH:D006323,Disease) :: ['cardiac arrest']
