Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202501811
Jornal Vascular Brasileiro
Artigo Original

Risco de complicações em cirurgia vascular: desenvolvimento de modelo clínico preditivo

Risk of complications in vascular surgery: development of a clinical predictive model

Juliana Peres; Jeferson Freitas Toregeani; Ana Julia Vendrametto

http://dx.doi.org/10.1590/1677-5449.202501811 J Vasc Bras, vol.25, e20250181, 2026
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Resumo

Contexto: Complicações pós-operatórias em cirurgia vascular estão associadas a elevada morbimortalidade e custos hospitalares, exigindo ferramentas preditivas confiáveis para estratificação de risco.

Objetivos: Desenvolver e validar um modelo clínico para estimar o risco de complicações pós-operatórias em cirurgia vascular.

Métodos: Estudo retrospectivo com 510 doentes submetidos a cirurgias vasculares entre 2021 e 2024, divididos em subgrupos arteriais, venosos e de acesso vascular. Variáveis clínicas e cirúrgicas foram analisadas por regressão logística multivariada, e o desempenho avaliado por meio da curva ROC.

Resultados: A taxa global de complicações foi de 17,6%, sendo maior nos procedimentos arteriais (35,6%) do que nos venosos (11,3%) e de acesso vascular (6,9%). Na amostra total, idade (odds ratio [OR] 1,03; p = 0,006), injúria renal crônica (OR 9,94; p < 0,001), tabagismo (OR 3,29; p = 0,001) e tempo de procedimento (p = 0,038) foram preditores independentes, enquanto o uso contínuo de anticoagulantes teve efeito protetor (OR 0,39; p = 0,036). Nos modelos específicos, diabetes melito tipo 2 (OR 13,54; p < 0,001) e injúria renal crônica (OR 15,30; p = 0,007) foram determinantes no grupo venoso; o tabagismo associou-se ao risco no grupo de acesso vascular (OR 9,57; p = 0,081); e a injúria renal crônica manteve significância no grupo arterial (OR 6,50; p < 0,001). O modelo demonstrou bom desempenho discriminativo (área sob a curva ROC [AUC] total = 0,806).

Conclusões: O modelo proposto mostrou boa acurácia e aplicabilidade clínica, permitindo estratificação de risco individualizada em diferentes contextos da cirurgia vascular. A validação externa é necessária para confirmar sua utilidade.

Palavras-chave

 cirurgia vascular; complicações pós-operatórias; avaliação de risco

Abstract

Background: Postoperative complications in vascular surgery are associated with high morbidity, mortality, and hospital costs, highlighting the need for reliable predictive tools for risk stratification.

Objectives:To develop and validate a clinical model to estimate the risk of postoperative complications in vascular surgery.

Methods: This retrospective study included 510 patients who underwent vascular surgeries between 2021 and 2024, divided into arterial, venous, and vascular access subgroups. Clinical and surgical variables were analyzed using multivariate logistic regression, and model performance was evaluated using the receiver operating characteristic curve.

Resultados: The overall complication rate was 17.6%, being higher in arterial procedures (35.6%) than venous procedures (11.3%) or vascular access surgeries (6.9%). In the total sample, age (odds ratio [OR] 1.03; p = 0.006), chronic kidney disease (OR 9.94; p < 0.001), smoking (OR 3.29; p = 0.001), and procedure time (p = 0.038) were independent predictors, while chronic anticoagulant use had a protective effect (OR 0.39; p = 0.036). In the specific subgroup models, type 2 diabetes mellitus (OR 13.54; p < 0.001) and chronic kidney disease (OR 15.30; p = 0.007) were significant predictors in the venous access group, smoking was associated with risk in the vascular access group (OR 9.57; p = 0.081), and chronic kidney disease was significant in the arterial group (OR 6.50; p < 0.001). The model showed good discriminatory performance (overall area under the curve [AUC] = 0.806).

Conclusions: The proposed model demonstrated good accuracy and clinical applicability, allowing individualized risk stratification across different vascular surgery contexts. External validation is needed to confirm its usefulness.

Keywords

vascular surgery; postoperative complications; risk assessment

Referências

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Submetido em:
30/09/2025

Aceito em:
29/01/2026

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