Troëng T, Bergqvist D, Janson L
Department of Surgery, Central Hospital, Karlskrona, Sweden.
Eur J Surg. 1994 Jan;160(1):17-25.
To assess the incidence of adverse outcomes after operation for chronic leg ischemia, to identify risk factors for an adverse outcome at one year, and to evaluate survival after operation.
Retrospective study.
University department.
1635 consecutive patients recorded on the Swedvasc registry, 1987-1989.
Data were analysed by logic regression and Cox's proportional hazards model.
Morbidity and mortality at 30 days, one year, and 1000 days.
At 30 days 54 of the 609 patients with claudication (8.8%) had either not improved or got worse, and this had increased to 126 (20.7%) at one year. Among the 1026 patients with critical ischaemia 124 had either had their limbs amputated or were dead at 30 days (12.2%), and the corresponding figure for one year was 359 (35.0%). Main factors associated with adverse outcome were age, heart disease, previous vascular surgery, reoperation within 30 days, and the presence of complications. Experience of the surgeon and the type of hospital were less important. At 1000 days 528 of the 609 patients with claudication (86.6%) were alive, compared with 628 of the 1026 with critical ischaemia (61.2%).*
Better selection of patients may improve the survival figures at one year. More aggressive treatment of coexistent diseases may improve the results in the group with claudication.
