Ljungman C, Holmberg L, Bergqvist D, Bergström R, Adami H O
Department of Surgery, Uppsala University Hospital, Sweden.
Eur J Vasc Endovasc Surg. 1996 Feb;11(2):176-82. doi: 10.1016/s1078-5884(96)80048-7.
To assess the outcome of embolectomy over an 19 year period.
Time trends in the outcome of acute arterial thrombo-embolectomy of the extremities were analysed in a population-based cohort of 1190 patients operated on between 1965-83.
A total of 262 (22%) initial amputations were performed. The limb salvage rates at 5 years postoperatively were lower between 1975-79 (61%) than between 1965-69 (81%). A proportional hazards model revealed a relative hazard (RH) of amputation of 2.2 (95% confidence interval (CI) 1.3-3.3) for 1975-79 compared with 1965-69. Operation at any district hospital entailed a 70% higher risk of amputation (RH 1.7; 95% CI 1.3-2.5) compared with the University hospital. The relative survival rate at 5 years postoperatively decreased towards the end of the study period (33% between 1975-79 compared with 43% between 1965-69). Younger age-groups had a considerably lower risk of death in the University hospital compared with the county and district hospitals.
Contrary to the results in other hospital based reports no improvement in amputation or survival rates since 1965 could be demonstrated in this large series with no patient selection.
评估19年期间动脉取栓术的治疗结果。
对1965年至1983年间接受手术的1190例基于人群队列的四肢急性动脉血栓栓塞取栓术治疗结果的时间趋势进行分析。
共进行了262例（22%）初次截肢手术。术后5年的肢体挽救率在1975 - 1979年期间（61%）低于1965 - 1969年期间（81%）。比例风险模型显示，与1965 - 1969年相比，1975 - 1979年截肢的相对风险（RH）为2.2（95%置信区间（CI）1.3 - 3.3）。与大学医院相比，在任何地区医院进行手术截肢风险高70%（RH 1.7；95% CI 1.3 - 2.5）。术后5年的相对生存率在研究期结束时下降（1975 - 1979年期间为33%，而1965 - 1969年期间为43%）。与县级和地区医院相比，大学医院中较年轻年龄组的死亡风险相当低。
与其他基于医院的报告结果相反，在这个未进行患者选择的大样本系列研究中，自1965年以来截肢率或生存率未显示出改善。
