Preoperative History of Gabapentinoids Use is Associated with Longer Length of Hospital Stay in Patients Undergoing Lower Extremity Bypass Surgery for Severe Peripheral Arterial Disease
Restricted (Penn State Only)
- Author:
- Samaan, Fadi
- Graduate Program:
- Clinical Research
- Degree:
- Master of Science
- Document Type:
- Master Thesis
- Date of Defense:
- March 12, 2025
- Committee Members:
- Terrence Edward Murphy, Thesis Advisor/Co-Advisor
Faisal Aziz, Committee Member
Li Wang, Professor in Charge/Director of Graduate Studies
Faisal Aziz, Thesis Advisor/Co-Advisor - Keywords:
- gabapentin
pregabalin
length of stay
peripheral artery disease
bypass
peripheral arterial disease
lower extremity bypass
Length of Stay - Abstract:
- Objective. This study aimed to assess the association of preoperative gabapentinoids (GBP) use with the postoperative length of stay for patients undergoing peripheral arterial lower extremity bypass surgery (LEB) for lifestyle limiting claudication and chronic limb threatening ischemia (CLTI) at a tertiary care hospital. Methods. Patients undergoing lower extremity bypass surgery during the period between 2000 to 2020 at Penn State Health Milton S. Hershey Medical Center were stratified into two groups based on the preoperative use of prescribed gabapentinoids (GBPs vs No GBPs). Patients’ preoperative characteristics, comorbidities and medications were assessed, and the outcomes of interest were analyzed in univariate analysis, stratified analysis and by multivariable regression models. Primary outcomes were 30-day mortality and length of stay. A p-value of <0.05 was considered significant for all the analyses. Results. The study cohort comprised 359 patients. The GBPs group comprised 125 patients with a mean (SD) age of 61.6 (±10.2) years and the No GBPs group consisted of 234 patients with a mean (SD) age of 64.6 (±12.2) years. Patients in GBPs group were likely to be younger (p=0.014), undergo LEB for CLTI (p=0.039) and have insulin dependent diabetes mellitus (p<0.001) in comparison to the No GBPs group. In terms of outcomes, the patients in the GBPs group were more likely to have longer postoperative length of stay (LOS; 9.3 ± 11.1 vs. 6.4 ± 5.0 days No GBPs, p=0.008). In multivariable analysis, the patients in the GBPs group had 92% (AOR 1.92 [1.16, 3.18], p=0.01) increase in the odds of having a LOS above 6-day calculated-median in comparison to the No GBPs group. Postoperative 30-day mortality did not differ between the two groups on chi square test (GBPs 28.8% vs 21.4% No GBPs, p=0.149). Conclusion: This retrospective analysis of patients undergoing LEB at a tertiary care hospital shows a significant association between preoperative gabapentinoids use and the longer postoperative length of stay. This study bridges a gap in the current body of knowledge regarding the association of GBP use with the postoperative outcomes in patients undergoing LEB for severe PAD.