Search: onr:"swepub:oai:gup.ub.gu.se/273344" >
Editor's Choice - I...
Editor's Choice - Impact of Comorbidity, Medication, and Gender on Amputation Rate Following Revascularisation for Chronic Limb Threatening Ischaemia
-
- Baubeta Fridh, Erik, 1982 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology,Ryhov Cty Hosp, Dept Radiol, Jonkoping, Sweden;Gothenburg Univ, Sahlgrenska Acad, Inst Clin Sci, Dept Radiol, Gothenburg, Sweden
-
- Andersson, Manne (author)
- Linköpings universitet,Avdelningen för Kirurgi, Ortopedi och Onkologi,Medicinska fakulteten,Ryhov Cty Hosp, Sweden
-
- Thuresson, M. (author)
- Statisticon AB, Uppsala, Sweden
-
show more...
-
- Sigvant, Birgitta (author)
- Uppsala universitet,Kärlkirurgi,Karlstad Cent Hosp, Dept Vasc Surg, Karlstad, Sweden,Karlstad Cent Hosp, Sweden; Uppsala Univ, Sweden
-
- Kragsterman, Björn (author)
- Uppsala universitet,Kärlkirurgi,Uppsala Univ, Sweden
-
- Johansson, S. (author)
- AstraZeneca Nord Balt, Sodertalje, Sweden
-
- Hasvold, P. (author)
- AstraZeneca Gothenburg, Molndal, Sweden
-
- Nordanstig, Joakim (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Gothenburg Univ, Sahlgrenska Univ Hosp & Acad, Dept Vasc Surg, Gothenburg, Sweden;Gothenburg Univ, Sahlgrenska Univ Hosp & Acad, Inst Med, Gothenburg, Sweden;Gothenburg Univ, Sahlgrenska Univ Hosp & Acad, Dept Mol & Clin Med, Gothenburg, Sweden
-
- Falkenberg, Mårten, 1959 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology,Gothenburg Univ, Sahlgrenska Acad, Inst Clin Sci, Dept Radiol, Gothenburg, Sweden
-
show less...
-
(creator_code:org_t)
- Elsevier BV, 2018
- 2018
- English.
-
In: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 56:5, s. 681-688
- Related links:
-
http://www.ejves.com...
-
show more...
-
https://gup.ub.gu.se...
-
https://doi.org/10.1...
-
https://urn.kb.se/re...
-
https://urn.kb.se/re...
-
show less...
Abstract
Subject headings
Close
- Objective/background: Chronic limb threatening ischaemia (CLTI) has a high risk of amputation and mortality. Increased knowledge on how sex, comorbidities, and medication influence these outcomes after revascularisation may help optimise results and patient selection. Methods: This population based observational cohort study included all individuals revascularised for CLTI in Sweden during a five year period (10,617 patients in total). Data were retrieved and merged from mandatory national healthcare registries, and specifics on amputations were validated with individual medical records. Results: Mean age at revascularisation was 76.8 years. Median follow up was 2.7 years (range 0-6.6 years). Male sex (hazard ratio [HR] 1.20, 95% confidence interval [CI] 1.09-1.33), renal insufficiency (HR 1.57, 95% CI 1.32-1.87), diabetes (HR 1.45, 95% CI 1.32-1.60), and heart failure (HR 1.17, 95% CI 1.05-1.31) were independently associated with an increased amputation rate, whereas the use of statins (HR 0.71, 95% CI 0.64-0.78) and low dose acetylsalicylic acid (HR 0.77, 95% CI 0.70-0.86) were associated with a reduced amputation rate. For the combined end point of amputation or death, an association with increased rates was found for male sex (HR 1.25, 95% CI 1.18-1.32), renal insufficiency (HR 1.94, 95% CI 1.75-2.14), heart failure (HR 1.50, 95% CI 1.40-1.60), and diabetes (HR 1.31, 95% CI 1.23-1.38). The use of statins (HR 0.74, 95% CI 0.67-0.82) and low dose acetylsalicylic acid (HR 0.82, 95% CI 0.77-0.881) were related to a reduced risk of amputation or death. Conclusions: Renal insufficiency is the strongest independent risk factor for both amputation and amputation/ death in revascularised CLTI patients, followed by diabetes and heart failure. Men with CLTI have worse outcomes than women. These results may help govern patient selection for revascularisation procedures. Statin and low dose acetylsalicylic acid are associated with an improved limb outcome. This underlines the importance of preventive medication to reduce general cardiovascular risk and increase limb salvage. (C) 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Amputation
- Arterial occlusive diseases
- Atherosclerosis
- Comorbidity
- Mortality
- Peripheral arterial
- peripheral artery-disease
- lower-extremity
- swedvasc registry
- vascular-surgery
- endovascular intervention
- practice guidelines
- diabetic-patients
- statin therapy
- reach registry
- free survival
- Surgery
- Amputation
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database