Gunnarsson Thordur, Gottsäter Anders, Bergman Stefan, Troëng Thomas, Lindgren Hans
Faculty of Medicine, Lund University, Lund, Sweden.
Department of Surgery, Helsingborg Hospital, Helsingborg, Sweden.
SAGE Open Med. 2020 May 24;8:2050312120926782. doi: 10.1177/2050312120926782. eCollection 2020.
Invasive treatment of infrainguinal intermittent claudication is controversial, and long-term outcomes are scarce. The study aim was to evaluate 8 years results regarding new vascular interventions on index and contralateral limb, hospitalization, mortality, and amputation in 775 patients revascularized for infrainguinal intermittent claudication in 2009.
Data on new vascular interventions retrieved from the Swedish vascular register (Swedvasc) were linked to the Inpatient Register and Cause of Death Register with information on hospitalizations, primary discharge diagnoses according to the 10th revision of the (ICD-10), deaths, causes of death, and amputations.
During 8 years of follow-up, 486 new vascular interventions were performed. Patients were admitted for a total of 4662 hospitalizations and spent 25,970 days in hospital. Between 79% and 99% of surviving subjects were hospitalized each year. During follow-up, 311 (40.1%) patients died. The most common causes of hospitalization and death were cerebrovascular disease, ischemic heart disease, or other diseases of the circulatory system, causing 47.5% of hospitalizations and 42.4% of deaths. Seventy-seven major lower limb amputations were performed in 52 patients.
As patients undergoing invasive treatment of infrainguinal intermittent claudication have high morbidity and mortality, during 8 years of follow-up, the indication for invasive treatment should be carefully weighed against concomitant comorbidities and the timing of this treatment optimized with regard to the patient's possibilities to enjoy positive treatment effects on quality of life.
下肢间歇性跛行的侵入性治疗存在争议,且长期结果稀缺。本研究旨在评估2009年接受下肢间歇性跛行血管重建术的775例患者在8年时关于首次手术侧和对侧肢体的新血管干预、住院情况、死亡率和截肢情况的结果。
从瑞典血管登记处(Swedvasc)获取的新血管干预数据与住院登记处和死亡原因登记处相链接,其中包含住院信息、根据国际疾病分类第10版(ICD - 10)的主要出院诊断、死亡情况、死亡原因和截肢情况。
在8年的随访期间,共进行了486次新血管干预。患者总共住院4662次,住院天数达25970天。每年有79%至99%的存活患者住院。随访期间,311例(40.1%)患者死亡。住院和死亡的最常见原因是脑血管疾病、缺血性心脏病或其他循环系统疾病,这些原因导致了47.5%的住院和42.4%的死亡。52例患者进行了77次主要下肢截肢手术。
由于接受下肢间歇性跛行侵入性治疗的患者具有较高的发病率和死亡率,在8年的随访期间,侵入性治疗的适应证应与合并症仔细权衡,并且应根据患者享受积极治疗效果以改善生活质量的可能性来优化这种治疗的时机。