{"title":"心血管手术后急性肢体缺血:死亡率极高的致命二合一。","authors":"Suci Indriani, Raditya Dewangga, Suko Adiarto, Taofan Siddiq, Iwan Dakota, Hananto Andriantoro, Marc Vuylsteke","doi":"10.1055/s-0043-1761290","DOIUrl":null,"url":null,"abstract":"<p><p>Acute limb ischemia (ALI) is a predictor of high morbidity and mortality. Previous studies showed that ALI developed after cardiac surgery may increase mortality. This study aimed to elucidate the clinical course and identify risk factors contributing to mortality in patients with ALI after cardiovascular surgery. This is a single-center retrospective cohort study. We analyzed data from 52 patients with ALI after cardiovascular surgery between 2016 and 2020. We evaluated the risk factors for 1-year mortality using Cox proportional hazards regression analysis. Most of the patients with ALI were male and the median age was 56 years (23-72 years). Most of the patients with ALI had coronary artery diseases. The 1-year mortality rate was 55.8% ( <i>n</i> = 29 patients). Multivariable analysis revealed that cardiopulmonary bypass (CPB) time ≥ 100 minutes (hazard ratio [HR]: 3.067, 95% confidence interval [CI]: 1.158-8.120) and postoperative acute kidney injury (HR: 2.927, 95% CI: 1.358-6.305) were significantly increasing the risk of mortality in patients with ALI after an operation. ALI after cardiovascular surgery was associated with high 1-year mortality in our study and long CPB time and postoperative acute kidney injury contributed to the mortality.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 3","pages":"158-164"},"PeriodicalIF":0.5000,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421682/pdf/","citationCount":"0","resultStr":"{\"title\":\"Acute Limb Ischemia after Cardiovascular Surgery: A Deadly Duo Combination with High Mortality.\",\"authors\":\"Suci Indriani, Raditya Dewangga, Suko Adiarto, Taofan Siddiq, Iwan Dakota, Hananto Andriantoro, Marc Vuylsteke\",\"doi\":\"10.1055/s-0043-1761290\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Acute limb ischemia (ALI) is a predictor of high morbidity and mortality. Previous studies showed that ALI developed after cardiac surgery may increase mortality. This study aimed to elucidate the clinical course and identify risk factors contributing to mortality in patients with ALI after cardiovascular surgery. This is a single-center retrospective cohort study. We analyzed data from 52 patients with ALI after cardiovascular surgery between 2016 and 2020. We evaluated the risk factors for 1-year mortality using Cox proportional hazards regression analysis. Most of the patients with ALI were male and the median age was 56 years (23-72 years). Most of the patients with ALI had coronary artery diseases. The 1-year mortality rate was 55.8% ( <i>n</i> = 29 patients). Multivariable analysis revealed that cardiopulmonary bypass (CPB) time ≥ 100 minutes (hazard ratio [HR]: 3.067, 95% confidence interval [CI]: 1.158-8.120) and postoperative acute kidney injury (HR: 2.927, 95% CI: 1.358-6.305) were significantly increasing the risk of mortality in patients with ALI after an operation. ALI after cardiovascular surgery was associated with high 1-year mortality in our study and long CPB time and postoperative acute kidney injury contributed to the mortality.</p>\",\"PeriodicalId\":13798,\"journal\":{\"name\":\"International Journal of Angiology\",\"volume\":\"32 3\",\"pages\":\"158-164\"},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2023-02-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421682/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Angiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1055/s-0043-1761290\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/9/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Angiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/s-0043-1761290","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
摘要
急性肢体缺血(ALI)是高发病率和高死亡率的预兆。以往的研究表明,心脏手术后发生的急性肢体缺血可能会增加死亡率。本研究旨在阐明心血管手术后急性肢体缺血患者的临床过程,并确定导致死亡率的风险因素。这是一项单中心回顾性队列研究。我们分析了2016年至2020年间52名心血管手术后ALI患者的数据。我们使用 Cox 比例危险回归分析评估了 1 年死亡率的风险因素。大部分ALI患者为男性,中位年龄为56岁(23-72岁)。大多数 ALI 患者患有冠状动脉疾病。1年死亡率为55.8%(29人)。多变量分析显示,心肺旁路(CPB)时间≥100 分钟(危险比 [HR]:3.067,95% 置信区间 [CI]:1.158-8.120)和术后急性肾损伤(HR:2.927,95% 置信区间 [CI]:1.358-6.305)会显著增加术后 ALI 患者的死亡风险。在我们的研究中,心血管手术后急性心肌梗死与高1年死亡率相关,而长CPB时间和术后急性肾损伤是导致死亡率的原因。
Acute Limb Ischemia after Cardiovascular Surgery: A Deadly Duo Combination with High Mortality.
Acute limb ischemia (ALI) is a predictor of high morbidity and mortality. Previous studies showed that ALI developed after cardiac surgery may increase mortality. This study aimed to elucidate the clinical course and identify risk factors contributing to mortality in patients with ALI after cardiovascular surgery. This is a single-center retrospective cohort study. We analyzed data from 52 patients with ALI after cardiovascular surgery between 2016 and 2020. We evaluated the risk factors for 1-year mortality using Cox proportional hazards regression analysis. Most of the patients with ALI were male and the median age was 56 years (23-72 years). Most of the patients with ALI had coronary artery diseases. The 1-year mortality rate was 55.8% ( n = 29 patients). Multivariable analysis revealed that cardiopulmonary bypass (CPB) time ≥ 100 minutes (hazard ratio [HR]: 3.067, 95% confidence interval [CI]: 1.158-8.120) and postoperative acute kidney injury (HR: 2.927, 95% CI: 1.358-6.305) were significantly increasing the risk of mortality in patients with ALI after an operation. ALI after cardiovascular surgery was associated with high 1-year mortality in our study and long CPB time and postoperative acute kidney injury contributed to the mortality.