Prognostic factors for amputation or death in patients submitted to vascular surgery for acute limb ischemia

Autor: Flávio Danni Fuchs, Ronaldo André Poerschke, Maurício Z. Vacaro, Clebes Fagundes, Almondi Fagundes
Rok vydání: 2005
Předmět:
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
Time Factors
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Embolism
Severity of Illness Index
Cohort Studies
Ischemia
Risk Factors
Trombose
Odds Ratio
Pharmacology (medical)
Prospective Studies
Prospective cohort study
Original Research
Hematology
General Medicine
Prognosis
Thrombosis
Treatment Outcome
Acute Disease
acute limb ischemia
Female
Cardiology and Cardiovascular Medicine
Vascular Surgical Procedures
Brazil
Cohort study
medicine.medical_specialty
Prognostic factors
Amputation
Surgical
Severity of illness
medicine
Humans
Acute limb ischemia
cardiovascular diseases
thrombosis
Embolia
Aged
business.industry
Public Health
Environmental and Occupational Health
prognostic factors
Extremities
Odds ratio
Vascular surgery
medicine.disease
Surgery
Isquemia
Logistic Models
Amputation
lcsh:RC666-701
business
Follow-Up Studies
Zdroj: Vascular Health and Risk Management
Vascular Health and Risk Management, Vol Volume 1, Pp 345-349 (2005)
Repositório Institucional da UFRGS
Universidade Federal do Rio Grande do Sul (UFRGS)
instacron:UFRGS
ISSN: 1176-6344
DOI: 10.2147/vhrm.2005.1.4.345
Popis: Clebes Fagundes1, Flávio Danni Fuchs2, Almondi Fagundes1, Ronaldo A Poerschke1, Maurício Z Vacaro11Divisions of Vascular Surgery, Hospital São Vicente de Paulo, Faculdade de Medicina da Universidade de Passo Fundo; 2Cardiology, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilObjective: To investigate the risk profile of patients with thrombosis and emboli, and prognostic factors for death or amputation in patients presenting with acute limb ischemia in a tertiary care regional hospital in Brazil.Methods: A prospectively planned cohort study was carried out in which 83 patients with acute limb ischemia, secondary to thrombosis, or embolism, classified in stages II and III of severity were evaluated. Univariate analysis and logistic regression models were used to explore the relationship between anthropometric and demographic characteristics, comorbidities, cardiovascular risk factors, duration of occlusion, and type of surgery with the incidence of amputation or death, which were evaluated in 30 days and 1 year thereafter.Results: Male gender, smoking, and comorbidities were more frequent among patients with thrombosis, and atrial fibrillation was more common among patients with embolism. Occlusion longer than 24 hours (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.1–7.6) and a trend for diabetes (RR 2.6, 95% CI 0.9–7.5) were the characteristics associated with death or amputation in the multivariate analysis, which occurred in 15 (18.1%) and 24 (28.9%) of the participants, respectively. Reperfusion injury was a risk factor for death but not for amputation (OR 16.9, 95% CI 1.1–232.9) after adjustment for age, duration of occlusion, and diabetes.Conclusions: Traditional and avoidable risk factors explain the occurrence of thrombosis and embolism in our region. Access to medical care is the most important and modifiable prognostic factor for death or amputation.Keywords: acute limb ischemia, embolism, thrombosis, prognostic factors
Databáze: OpenAIRE
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