Incidência e fatores relacionados à revascularização arterial cirúrgica em um hospital terciário no norte gaúcho

Abstract

Objectives: To describe the clinical and epidemiological profile of patients undergoing vascular procedures; to estimate the incidence of surgical arterial revascularization; to characterize arterial bypass and embolectomy procedures; and to analyze factors associated with their performance. Methods: This was a retrospective cohort study with a descriptive and analytical approach, conducted at the Vascular Surgery Department of a tertiary hospital in northern Rio Grande do Sul, Brazil. Data from patients treated between January 2019 and December 2022 were analyzed, obtained from electronic medical records. Variables included sociodemographic characteristics, risk factors, comorbidities, and procedure-specific features. Statistical analysis was performed using PSPP software (version 1.6.2), applying descriptive statistics and chi-square or Fisher’s exact tests, with a significance level of 5%. Results: The sample comprised 1,229 patients, predominantly male (58.6%), elderly (78.9% ≥60 years), White (95.4%), and with incomplete secondary education (57.0%). The incidence of surgical arterial revascularization was 15.5% (95% CI: 13.4–17.5), with 9.0% undergoing bypass and 8.1% embolectomy. A higher frequency of revascularization was observed among males (17.6%; p=0.012). Significant differences were found in relation to smoking (23.0%; p<0.001), alcohol use (31.8%; p<0.001), type 1 diabetes mellitus (29.4%; p=0.026), acute peripheral arterial occlusion (41.6%; p<0.001), popliteal artery aneurysm (36.8%; p=0.009), and deep vein thrombosis (29.8%; p=0.002). Bypass procedures were mainly performed in the femoropopliteal segment (44.4%), while embolectomies predominantly occurred in the same territory (52.7%). Conclusion: Surgical arterial revascularization showed a low incidence in the studied setting and was associated with relevant clinical and behavioral factors. These findings reinforce the selective role of open surgery in more complex cases and contribute to improving risk stratification and clinical decision-making.