Risk-scoring method for prediction of 30-day postoperative outcome after infrainguinal surgical revascularization for critical lower-limb ischemia:: a Finnvasc registry study
Risk-scoring method for prediction of 30-day postoperative outcome after infrainguinal surgical revascularization for critical lower-limb ischemia:: a Finnvasc registry study
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DOI：
10.1007/s00268-006-0242-y
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发表时间：
2007-01-01
影响因子：
2.6
通讯作者：
Lepantalo, Mauri
中科院分区：
文献类型：
--
作者：
Biancari, Fausto;Salenius, Juha-Pekka;Lepantalo, Mauri
背景：本研究的目的是开发一种风险评分方法来预测严重肢体缺血腹股沟下手术血运重建术后的即刻结果。方法：FinnVasc登记了3925例腹股沟下手术血运重建手术的数据。结果：在整个系列中，术后30天的死亡率和大腿截肢率分别为3.1%和6.3%。术后30d死亡率和(或)肢体损失率为9.2%。糖尿病、冠状动脉疾病、足部坏疽和紧急手术是术后30天死亡率和/或主要下肢截肢的独立预测因素。通过为后一种风险因素各分配1分，得出了风险评分。在推导数据集中，评分为0、1、2、3和4分的患者术后30天死亡率/截肢率分别为7.7%、6.4%、11.1%、20.4%和27.3%(P<；0.0001)，死亡率分别为1.3%、2.3%、4.1%、7.7%和12.1%(P<；0.0001)；大腿截肢率分别为6.4%、4.3%、7.1%、12.7%和18.2%(P<；0.0001)。在验证数据集中，评分为0、1、2、3和4的患者术后30天的死亡率/截肢率分别为4.8%、7.5%、10.1%、15.9%和22.2%(P<；0.0001)，死亡率分别为0.7%、2.3%、4.2%、5.5%和14.8%(P<；0.0001)；大腿截肢率分别为4.6%、5.3%、6.4%、11.0%和14.0%(P=0.011)。结论：这种简单的风险评分方法可用于对接受腹股沟下血管重建术的严重下肢缺血患者的术后近期预后进行分层。
Background: The aim of the present study was to develop a risk-scoring method for prediction of immediate postoperative outcome after infrainguinal surgical revascularization for critical limb ischemia.Methods: The Finnvasc registry included data on 3,925 infrainguinal surgical revascularization procedures. This database was randomly divided into a derivation and a validation data set of similar sizes.Results: In the overall series, 30-day postoperative mortality and major amputation rates were 3.1% and 6.3%, respectively. The 30-day postoperative mortality and/or limb-loss rate was 9.2%. Diabetes, coronary artery disease, foot gangrene, and urgent operation were independent predictors of 30-day postoperative mortality and/or major lower-limb amputation. A risk score was developed by assigning 1 point each to the latter risk factors. In the derivation data set, the 30-day postoperative mortality/amputation rates in patients with scores of 0, 1, 2, 3, and 4 were 7.7%, 6.4%, 11.1%, 20.4%, and 27.3%, respectively, (P < 0.0001); mortality rates were 1.3%, 2.3%, 4.1%, 7.7%, and 12.1%, respectively, (P < 0.0001); and major amputation rates were 6.4%, 4.3%, 7.1%, 12.7%, and 18.2%, respectively, (P < 0.0001). In the validation data set, the 30-day postoperative mortality/amputation rates in patients with scores of 0, 1, 2, 3, and 4 were 4.8%, 7.5%, 10.1%, 15.9%, and 22.2%, respectively, (P < 0.0001); mortality rates were 0.7%, 2.3%, 4.2%, 5.5%, and 14.8%, respectively, (P < 0.0001); and major amputation rates were 4.6%, 5.3%, 6.4%, 11.0%, and 14.0%, respectively (P = 0.011).Conclusions: This simple risk-scoring method can be useful to stratify the immediate postoperative outcome of patients undergoing infrainguinal surgical revascularization for critical lower-limb ischemia.