Functional ambulatory status as a potential adjunctive decision-making tool following wound, level of ischemia, and severity of foot infection assessment
| Autor: | Stephanie L Woelfel, Laura Shin, Tanzim Khan, Kenneth R. Ziegler, David G. Armstrong, Gregory A. Magee, Chia Ding Shih, Anastasia Plotkin, Fred A. Weaver, Vincent L. Rowe |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Health Status medicine.medical_treatment Limb salvage Clinical Decision-Making Ischemia 030204 cardiovascular system & hematology Severity of Illness Index Article Peripheral Arterial Disease 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Clinical Decision Rules medicine Humans 030212 general & internal medicine Mobility Limitation business.industry Patient Selection Ambulatory Status Vascular surgery Prognosis medicine.disease Dependent Ambulation Amputation Chronic Disease Ambulatory Wound Infection Physical therapy Surgery Functional status Cardiology and Cardiovascular Medicine business Foot (unit) |
| Zdroj: | J Vasc Surg |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/j.jvs.2019.11.064 |
| Popis: | The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System has been developed to stratify amputation risk on the basis of extent of the wound, level of ischemia, and severity of foot infection (WIfI). However, there are no currently validated metrics to assess, grade, and consider functional status, especially ambulatory status, as a major consideration during limb salvage efforts. Therefore, we propose an adjunct to the current WIfI system to include the patient’s ambulatory functional status after initial assessment of limb threat. We propose a functional ambulatory score divided into grade 0, ambulation outside the home with or without an assistive device; grade 1, ambulation within the home with or without an assistive device; grade 2, minimal ambulation, limbs used for transfers; and grade 3, a person who is bed-bound. Adding ambulatory function as a supplementary assessment tool can guide clinical decision making to achieve optimal future functional ambulatory outcome, a patient-centered goal as critical as limb preservation. This adjunct may aid limb preservation teams in rapid, effective communication and clinical decision making after initial WIfI assessment. It may also improve efforts toward patient-centered care and functional ambulatory outcome as a primary objective. We suggest a score of functional ambulatory status should be included in future trials of patients with chronic limb-threatening ischemia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|