When to call it a day: incremental risk of amputation and death after multiple revascularization

Annals of Vascular Surgery
Alexander T HawkinsLouis L Nguyen

Abstract

Patients with critical limb ischemia (CLI) often undergo revascularization before amputation. The exact relationship between multiple procedures and increased risk of amputation is unclear. We sought to determine the increased risk of amputation for each additional revascularization. The 2007-2009 California State Inpatient Database (SID) was used to identify a cohort of CLI patients undergoing revascularization and conduct a time-to-event analysis for patients undergoing one or more revascularization procedures. One-year estimates were generated with Kaplan-Meier curves and compared with the log-rank test. The Wei-Lin-Weissfeld (WLW) marginal proportional hazards model was used to assess independent effects of number of revascularization procedures on amputation and death. A total of 11,190 patients with CLI underwent revascularization between July 2007 and December 2009. Their mean age was 71.0 years (interquartile range 62-80 years) and 6255 (55.9%) were male. Over half the subjects (55.2%) were smokers and there was a high burden of comorbidities in the cohort. One-year estimates of amputation by number of revascularizations (1: 23.3%; 2: 27.1%; 3: 30.3%; 4: 26.7%; 5(+): 28.6%; P < 0.001) and death (1: 18.7%; 2: 21.1%; 3: 2...Continue Reading

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Citations

Nov 22, 2015·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·J J van NettenJ M Hijmans
Oct 10, 2020·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Tanner I KimPeter A Schneider
Mar 6, 2021·Current Cardiology Reports·E Hope WeisslerRajesh V Swaminathan

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