Indriani Suci, Dewangga Raditya, Adiarto Suko, Siddiq Taofan, Dakota Iwan, Andriantoro Hananto, Vuylsteke Marc
Department of Cardiology and Vascular Medicine, Universitas Indonesia/Harapan Kita National Cardiovascular Center, Jakarta, Indonesia.
Department of Emergency Medicine, Gunung Jati General Hospital, Cirebon, Indonesia.
Int J Angiol. 2023 Feb 13;32(3):158-164. doi: 10.1055/s-0043-1761290. eCollection 2023 Sep.
Acute limb ischemia (ALI) is a predictor of high morbidity and mortality. Previous studies showed that ALI developed after cardiac surgery may increase mortality. This study aimed to elucidate the clinical course and identify risk factors contributing to mortality in patients with ALI after cardiovascular surgery. This is a single-center retrospective cohort study. We analyzed data from 52 patients with ALI after cardiovascular surgery between 2016 and 2020. We evaluated the risk factors for 1-year mortality using Cox proportional hazards regression analysis. Most of the patients with ALI were male and the median age was 56 years (23-72 years). Most of the patients with ALI had coronary artery diseases. The 1-year mortality rate was 55.8% ( = 29 patients). Multivariable analysis revealed that cardiopulmonary bypass (CPB) time ≥ 100 minutes (hazard ratio [HR]: 3.067, 95% confidence interval [CI]: 1.158-8.120) and postoperative acute kidney injury (HR: 2.927, 95% CI: 1.358-6.305) were significantly increasing the risk of mortality in patients with ALI after an operation. ALI after cardiovascular surgery was associated with high 1-year mortality in our study and long CPB time and postoperative acute kidney injury contributed to the mortality.
急性肢体缺血（ALI）是高发病率和死亡率的一个预测指标。既往研究表明，心脏手术后发生的ALI可能会增加死亡率。本研究旨在阐明心血管手术后ALI患者的临床病程，并确定导致死亡的危险因素。这是一项单中心回顾性队列研究。我们分析了2016年至2020年间52例心血管手术后发生ALI患者的数据。我们使用Cox比例风险回归分析评估了1年死亡率的危险因素。大多数ALI患者为男性，中位年龄为56岁（23 - 72岁）。大多数ALI患者患有冠状动脉疾病。1年死亡率为55.8%（n = 29例患者）。多变量分析显示，体外循环（CPB）时间≥100分钟（风险比[HR]：3.067，95%置信区间[CI]：1.158 - 8.120）和术后急性肾损伤（HR：2.927，95% CI：1.358 - 6.305）显著增加了心血管手术后ALI患者的死亡风险。在我们的研究中，心血管手术后的ALI与1年高死亡率相关，长CPB时间和术后急性肾损伤是导致死亡的原因。
