Analysis of a Large 19-Year Database in Vascular Surgery in Southern Iran: Evaluation of Trends and Limitations.

INTRODUCTION: Large databases with data elements of clinical interest are essential for carrying out high-quality observational studies. Such databases have become increasingly popular for clinical research in fields like Vascular Surgery. Our goal is to create a solid and reliable database of the patients who have been admitted and undergone different vascular-surgery procedures over 19 years and to provide surgeons with the current trends and limitations in managing patients with vascular disease.

METHOD: The database of patients operated in Namazi Hospital, the referral center for Vascular Surgery in southern Iran, from 2001 to 2019, was retrieved and patients undergoing vascular procedures were parted. Demographic and perioperative data were evaluated and patients were categorized into subgroups based on the type and cause of operation. All data were analyzed with SPSS version 26.0 (IBM. NY. USA).

RESULTS: During the period of our study, a total of 226,051 operations were performed at the Namazi Hospital. Among these operations, 6,386 (2.82%) Vascular Surgery-related operations were entered into our study. The average age of the patients in our study was 53.22 ± 18.92 years (range: 1 day old - 97 years) and 4,061 (63.6%) were male. Furthermore, 147 (2.3%) were operated by multiple surgeons. Moreover, 798 (12.5%) of the patients were admitted postoperatively to the intensive care unit (ICU), while the rest (5,588; 87.5%) in the common surgery ward. The cause of operation in 609 (9.5%) of the cases was trauma. Based on wound categorization, 5,132 (80.4%) were type I (clean). The most frequent operation performed in our center was arterial reconstruction and limb revascularization (31.4%), followed by hemodialysis access (31.3%). The most frequent surgery in the age group of under 18 years was fasciotomy, in the 19 to 40 years group was tumor (56.8%) and varicose veins (52.9%), in the 41 to 60 years group was implantation of ventral venous port catheter (47%). Only carotid and thoracic outlet syndrome surgeries were significantly higher in females. The remaining operations were all significantly higher among male patients. Finally, carotid body tumor surgery was the most frequent operation requiring ICU monitoring.

CONCLUSION: We demonstrated, for the first time, an overview of Vascular Surgeries performed in a referral tertiary center in Southwest Iran. There is an increase in the number of surgical procedures in the field of Vascular Surgery, and large databases will be a valuable tool for addressing critical problems in this field and also the healthcare system.