危及肢体的慢性缺血并不包括同质人群:是时候进行更详细的分类了

IF 0.5 Q4 PERIPHERAL VASCULAR DISEASE
Schraepen Cédric, van der Laan Lijckle, Smet Nick, Meulenbroek Anne, Fourneau Inge
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引用次数: 0

摘要

摘要 目的 慢性肢体缺血(CLTI)与高发病率和高死亡率有关。分类方法可将患者分为静息痛患者和缺血性溃疡患者。对于缺血性溃疡患者是否存在静息痛并无区分。我们的目的是确定这些分类之间的结果差异,从而改进术前咨询和风险评估。方法 这项多中心回顾性队列研究纳入了 2013 年至 2018 年间因首次发作 CLTI 而接受血管重建的所有患者。队列分为三组:仅有静息痛(RP)的患者、仅有缺血性溃疡(IU)的患者、同时有静息痛和缺血性溃疡(RP + IU)的患者。对基线特征、发病率和死亡率进行了分析。结果 共纳入了 599 名患者的 624 个肢体:静息痛组有 225 例(36.1%),缺血性溃疡组有 169 例(27.1%),综合组有 230 例(36.2%)。6 个月后,综合组的截肢率更高。缺血性溃疡组和合并组在 6 个月和 1 年后的死亡率明显更高。结论 与缺血性溃疡患者相比,仅有静息痛的患者死亡率明显较低。静息痛并不影响溃疡患者的死亡率。合并有静息痛和缺血性溃疡的患者截肢率较高,因为静息痛CLTI患者对截肢风险有显著的负面影响。建议对合并溃疡和静息痛的患者进行单独分组。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Chronic Limb-Threatening Ischemia does not Enclose a Homogenous Population: Time for a More Detailed Classification
Abstract Objective  Chronic limb-threatening ischemia (CLTI) is associated with high morbidity and mortality. Classification methods differentiate into patients with rest pain or with ischemic ulcers. No distinction is made between the presence or absence of rest pain in patients with ischemic ulcers. Our aim is to determine any differences in outcome between these subdivisions so we can improve preoperative counseling and risk assessment. Methods  This multicenter retrospective cohort study included all patients revascularized for a first episode of CLTI between 2013 and 2018. The cohort was divided in three groups: patients with solely rest pain (RP), solely ischemic ulcers (IU), and patients with both rest pain and ischemic ulcers (RP + IU). Baseline characteristics, morbidity, and mortality were analyzed. Results  A total of 624 limbs in 599 patients were included: 225 (36.1%) in the rest pain group, 169 (27.1%) in the ischemic ulcers group, and 230 (36.2%) in combined group. Amputation rates were higher in the combined group at 6 months. Mortality rates were significantly higher in the ischemic ulcers group and the combined group at 6 months and 1 year. Conclusions  Patients with solely rest pain have significantly lower mortality rates in comparison to patients with ischemic ulcers. Rest pain did not affect mortality rates in patients with ulcers. There was a higher amputation rate in patients with combined rest pain and ischemic ulcers because the presence of rest pain CLTI patients had a significant negative effect on amputation risk. A separate subdivision for patients with combined ulcers and rest pain is indicated.
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来源期刊
International Journal of Angiology
International Journal of Angiology PERIPHERAL VASCULAR DISEASE-
CiteScore
1.30
自引率
16.70%
发文量
57
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