Risk factors associated with major amputation following open revascularization in patients with ALI
| Variables | Major amputation | ||
|---|---|---|---|
| OR | 95% CI | p value | |
| Age | 0.92 | 0.61–1.37 | 0.674 |
| Ischemic heart disease | 1.32 | 0.58–3.01 | 0.511 |
| Chronic heart failure | 0.74 | 0.26–2.12 | 0.583 |
| Peripheral arterial disease | 2.45 | 1.02–5.92 | 0.046 |
| History of myocardial | 0.77 | 0.16–3.63 | 0.749 |
| infarction | |||
| Diabetes mellitus | 1.16 | 0.48–2.79 | 0.729 |
| WBCs | 1.92 | 1.29–2.85 | 0.001 |
| Neutrophils | 1.44 | 0.98–2.12 | 0.057 |
| Lymphocytes | 1.14 | 0.75–1.73 | 0.536 |
| Monocytes | 1.67 | 1.15–2.43 | 0.007 |
| Platelets | 1.51 | 1.04–2.21 | 0.031 |
| Upper limb ALI | 0.29 | 0.09–0.88 | 0.030 |
Risk factors associated with in-hospital mortality following open revascularization in patients with ALI
| Variables | In-hospital mortality | ||
|---|---|---|---|
| OR | 95% CI | p value | |
| Age | 1.14 | 0.72-1.82 | 0.573 |
| Ischemic heart disease | 1.92 | 0.76–4.82 | 0.168 |
| Chronic heart failure | 2.77 | 1.08–7.06 | 0.033 |
| Peripheral arterial disease | 0.52 | 0.15–1.86 | 0.317 |
| History of myocardial | 3.85 | 1.19–12.41 | 0.024 |
| infarction | |||
| Diabetes mellitus | 3.23 | 1.29–8.03 | 0.012 |
| WBCs | 1.51 | 1.02–2.24 | 0.041 |
| Neutrophils | 1.98 | 1.32–2.97 | <0.001 |
| Lymphocytes | 0.58 | 0.34–0.98 | 0.042 |
| Monocytes | 1.19 | 0.79–1.80 | 0.399 |
| Platelets | 1.37 | 0.91–2.06 | 0.128 |
| Upper limb ALI | 0.39 | 0.13–1.22 | 0.106 |
Baseline characteristics of the study population, based on the location of ALI
| Variable | All patients (n = 177) | Upper limb (n = 60) | Lower limb (n = 117) | p value |
|---|---|---|---|---|
| Age, mean ± s.d. | 71.37 ± 14.48 | 68.21 ± 14.63 | 73.0 ± 14.19 | 0.041 |
| Male, n (%) | 90 (50.85%) | 32 (53.33%) | 58 (49.57%) | 0.636 |
| Comorbidities and risk factors, n (%) | ||||
| Hypertension | 133 (75.14%) | 44 (73.33%) | 89 (76.07%) | 0.690 |
| Ischemic heart disease | 88 (49.72%) | 23 (38.33%) | 65 (55.56%) | 0.030 |
| Chronic heart failure | 40 (22.60%) | 7 (11.67%) | 33 (28.21%) | 0.013 |
| Chronic kidney disease | 31 (17.51%) | 8 (13.33%) | 23 (19.66%) | 0.295 |
| Peripheral arterial disease | 39 (22.03%) | 3 (5.00%) | 36 (30.77%) | <0.001 |
| Atrial fibrillation | 77 (43.50%) | 22 (36.67%) | 55 (47.01%) | 0.189 |
| Diabetes | 50 (28.25%) | 12 (20.0%) | 38 (32.48%) | 0.138 |
| History of myocardial infarction | 16 (9.04%) | 3 (5.00%) | 13 (11.11%) | 0.180 |
| History of stroke | 26 (14.69%) | 8 (13.33%) | 18 (15.38%) | 0.715 |
| Malignancy | 17 (9.60%) | 6 (10.00%) | 11 (9.40%) | 0.898 |
| Active smoking | 34 (19.21%) | 11 (18.33%) | 23 (19.66%) | 0.832 |
| Dyslipidemia | 25 (14.12%) | 10 (16.67%) | 15 (12.82%) | 0.487 |
| Laboratory data, median (Q1–Q3) | ||||
| WBCs | 11.11 (8.34–13.75) | 10.60 (8.25–12.56) | 11.41 (8.51–14.41) | 0.167 |
| Red blood cells | 4.47 (4.01–4.85) | 4.63 (4.16–4.96) | 4.37 (3.97–4.79) | 0.034 |
| K, mmol/l | 4.15 (3.78–4.61) | 4.14 (3.81–4.71) | 4.16 (3.78–4.55) | 0.843 |
| Na, mmol/l | 140 (137–142) | 141 (138–142) | 140 (137–142) | 0.293 |
| Glucose, mg/dl | 118.0 (98.0–164.9) | 111.0 (95.0–141.95) | 121.0 (100.0–169.75) | 0.100 |
| Urea, mg/dl | 42.80 (32.1–59.92) | 44.94 (31.35–60.46) | 42.40 (34.24–59.71) | 0.849 |
| Creatinine, mg/dl | 0.95 (0.78–1.33) | 0.97 (0.78–1.21) | 0.93 (0.79–1.37) | 0.929 |
| Creatin kinase | 277.5 (88.6–1920.25) | 159.0 (86.2–481.0) | 500.0 (100.0–3079.0) | 0.013 |
| Hemoglobin, g/dl | 13.38 (11.9–14.58) | 14.10 (12.3–15.45) | 13.10 (11.8–14.3) | 0.010 |
| Hematocrit, % | 40.51 (36.9–43.9) | 41.86 (38.61–46.0) | 40.10 (35.99–42.93) | 0.011 |
| Neutrophils, × 103/μl | 8.91 (5.69–11.49) | 7.57 (5.39–10.05) | 9.34 (5.94–12.07) | 0.017 |
| Lymphocytes, × 103/μl | 1.70 (1.21–2.29) | 1.66 (1.14–2.32) | 1.72 (1.29–2.24) | 0.858 |
| Monocytes, × 103/μl | 0.75 (0.55–1.08) | 0.68 (0.51–0.87) | 0.80 (0.59–1.12) | 0.034 |
| Platelets, × 103/μl | 234.70 (188.5–310.0) | 231.0 (191.0–279.5) | 238.0 (188.25–334.0) | 0.207 |
| Surgical interventions, n (%) | ||||
| Embolectomy | 156 (88.14%) | 51 (85.00%) | 104 (89.74%) | 0.356 |
| Endarterectomy | 7 (3.95%) | 1 (1.67%) | 6 (5.13%) | 0.263 |
| Bypass | 14 (7.91%) | 2 (3.33%) | 12 (10.26%) | 0.106 |
| Anesthesia, n (%) | ||||
| Local anesthesia | 59 (33.33%) | 38 (63.33%) | 21 (17.95%) | <0.001 |
| Regional block anesthesia | 11 (6.21%) | 1 (1.67%) | 10 (8.55%) | 0.053 |
| General anesthesia | 100 (56.50%) | 15 (25.00%) | 85 (72.65%) | <0.001 |
| Major amputation, n (%) | 27 (15.25%) | 4 (6.67%) | 23 (19.66%) | 0.023 |
| In-hospital mortality, n (%) | 22 (12.43%) | 4 (6.67%) | 18 (15.38%) | 0.096 |
| Length of stay, days, mean ± s.d. | 6.78 ± 8.96 | 4.37 ± 3.35 | 8.02 ± 10.56 | <0.001 |
Characterization of thrombosed arterial segments in patients with ALI affecting both upper and lower extremities
| Upper limb (n = 60), n (%) | |
|---|---|
| Subclavian artery | 6 (10.0%) |
| Axillary artery | 15 (25.0%) |
| Brachial artery | 45 (75.0%) |
| Radial artery | 32 (53.33%) |
| Ulnar artery | 30 (50.0%) |
| 1 artery involved | 21 (35.0%) |
| >1 artery involved | 39 (65.0%) |
| >2 arteries involved | 27 (45.0%) |
| >3 arteries involved | 5 (8.33%) |
| Lower limb (n = 117), n (%) | |
| Common iliac artery | 20 (17.09%) |
| External iliac artery | 25 (21.36%) |
| Common femoral artery | 49 (41.88%) |
| Superficial femoral artery | 88 (75.21%) |
| Profunda femoral artery | 33 (28.20%) |
| Popliteal artery | 95 (81.19%) |
| 1 artery involved | 25 (21.37%) |
| >1 artery involved | 92 (78.63%) |
| >2 arteries involved | 58 (49.57%) |
| >3 arteries involved | 32 (27.35%) |
| >4 arteries involved | 9 (7.69%) |