Prevent III score as a predictor of limb salvage and mortality after aortoiliac revascularization.

BACKGROUND

This prospective study aimed to validate the prognostic value of Prevent III (PIII) risk score in patients undergoing aortoiliac revascularization, both in limb-related outcomes and cardiovascular risk.

METHODS

The prospective cohort study included 130 consecutive patients (122 males, 8 females; mean age: 62.1±9.2 years; range, 53 to 71 years) undergoing elective aortoiliac revascularization between January 2013 and September 2022. Patients' demographic and clinical characteristics were retrieved and PIII scores were calculated. A risk category was assigned according to the total points: low-risk (score ≤3), medium-risk (score 4-7), or high-risk (score ≥8).

RESULTS

The median follow-up period was 55 months (interquartile range, 39 to 70 months). Twenty-four (18.5%) patients had a PIII score ≥4. Regarding short-term outcomes, patients with PIII scores ≥4 exhibited lower ankle-brachial index changes at 30 days and more extended hospital stays. There were no significant associations between PIII scores and major adverse events at 30 days. However, during follow-up, a PIII score ≥4 was associated with increased major adverse limb events (p=0.036) and all-cause mortality (p=0.007).

CONCLUSION

The PIII score is a reliable predictor of long-term limb and mortality risk in patients undergoing aortoiliac revascularization procedures, leveraging five user-friendly clinical parameters. More research with larger cohorts and studies comparing PIII with other validated scores should be performed in the future.