Influence of frailty on treatment outcomes after revascularization in patients with critical limb ischemia
Influence of frailty on treatment outcomes after revascularization in patients with critical limb ischemia
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DOI：
10.1016/j.jvs.2017.04.048
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发表时间：
2017-12-01
影响因子：
4.3
通讯作者：
Ohmine, Takahiro
中科院分区：
文献类型：
--
作者：
Morisaki, Koichi;Yamaoka, Terutoshi;Ohmine, Takahiro
目的：目前尚不清楚虚弱是否会对严重肢体缺血（CLI）患者的治疗结果产生不利影响。本研究的目的是调查虚弱对CLI患者血运重建后的影响。方法：回顾性分析2007年至2015年期间接受膝下血运重建的患者。当存在以下两种或两种以上情况时，患者被定义为CLI虚弱：低老年营养风险指数、低骨骼肌质量指数或卧床状态。主要研究终点是2年无截肢生存率（AFS）。为了分析虚弱的诊断标准，CLI虚弱指数与使用曲线下受试者工作特征面积的改良虚弱指数进行比较。次要终点是Clavien-Dindo IV级并发症的发生率和30天或住院mortality.Results：在研究期间，266例患者和325条肢体接受了膝下血管重建术。术后1年和2年的AFS发生率，CLI虚弱组分别为81.8%和72.9%，CLI虚弱+组分别为45.8%和34.0%（P
Objective: It is unclear whether frailty adversely affects treatment outcomes in patients with critical limb ischemia (CLI). The aim of this study was to investigate the influence of frailty on CLI patients after revascularization.Methods: Patients undergoing infrapopliteal revascularization between 2007 and 2015 were retrospectively analyzed. The patient was defined as CLI frail when two or more of the following were present: low Geriatric Nutritional Risk Index, low skeletal muscle mass index, or nonambulatory status. The primary study end point was 2-year amputation-free survival (AFS). To analyze the diagnostic criteria of frailty, the CLI Frailty Index was compared with amodified Frailty Index using a receiver operating characteristic area under the curve. The secondary end points were occurrence of Clavien-Dindo class IV complications and 30-day or hospital mortality.Results: During the study period, 266 patients and 325 limbs underwent infrapopliteal revascularization. The AFS rate 1 year and 2 years after revascularization was 81.8% and 72.9% for the CLI frail - group vs 45.8% and 34.0% for the CLI frail+group (P