Abstract 12179: Predictors of Early Mortality in Patients with Critical Limb Ischemia
Background: It has already been reported that presence of critical limb ischemia (CLI) associated with high mortality and morbidity. However, predictors of early mortality in patients with CLI remain unclear. In this study, we sought to investigate the predictors of early mortality in patients with CLI.
Methods: This study was multicenter retrospective observational study of prospective maintained database. From April 2004 to October 2010, total of 744 patients (872 limbs) with CLI who underwent femoropopliteal stenting (255 limbs), below-the-knee angioplasty (458 limbs), and infrainguinal bypass surgery (159 limbs) were enrolled. Outcome measure was all-cause mortality within a year.
Results: Mean follow-up period was 524 ± 464 days. Sixty-six percent were male, 68% had diabetes, 67% had chronic renal failure (defined as creatinine > 2.0 mg/dl), 35% had Cerebro-vascular disease, and 15% were with anemia (defined as hemoglobin < 9.0g/dl). Mean age was 72 ± 10 years. Rutherford class IV was found in 218 limbs, V in 514 limbs and VI in 140 limbs. Mean ankle-brachial index before initial procedure was 0.66 ± 0.31. All-cause death within a year was accounted for 19.8%. Limb salvage rate was 89.6% during the follow-up. Multivariate logistic regression analysis was performed to determine predictors of early mortality. Age, anemia, chronic renal failure, less than 0.5 of ABI before procedure, and Rutherford class were independent predictors of all-cause death.
Conclusion: In patients with CLI, Age, anemia, chronic renal failure, less than 0.5 of ABI before procedure, and Rutherford class were the independent predictors of early mortality. Patients who have these predictors may indicate endovascular treatment which is less invasive than open bypass surgery.
- © 2011 by American Heart Association, Inc.