• 作者：José ; Marí ; a Mostaza^a ; ^{jmostaza.hciii@salud.madrid.org} ; Enrique Puras^b ; Javier Á ; lvarez^c ; Marc Cairols^d ; Vicente Garcí ; a-Rospide^e ; Manuel Miralles^f ; José ; Romá ; n Escudero^g ; Agustí ; n Arroyo Bielsa^h ; en nombre de los investigadores del estudio ICEBERG^&loz ;
• 关键词：Enfermedad arterial perif&eacute ; rica ; Isquemia crí ; tica de miembros inferiores ; Diabetes ; Revascularizació ; n ; Amputació ; n
• 刊名：Medicina Cl铆nica
• 出版年：2011
• 期刊代码：pca254_00257753
• 类别：med
• 出版时间：12 February 2011
• 卷：136
• 期：3
• 页码：91-96
• 文件大小：179 K

Background and objectives

Critical leg ischemia (CLI) is a medical emergency with a high morbidity and mortality. Although its prognosis has improved during the last years, there are no data on its clinical characteristics, treatment and in-hospital prognosis in our country.

Patients and method

671 patients (81%males, mean age 71.2 years) with atherosclerotic CLI, attended in 46 departments of vascular surgery were included in the study.

Results

Participants had a high prevalence of cardiovascular risk factors (72%hypertensive, 27%current smokers, 59%diabetics) and comorbidity (25%coronary heart disease, 18%cerebrovascular disease). 71%had a previous diagnosis of peripheral arterial disease. Upon admission, 71%were referred for revascularization, 5%for direct amputation and 24%for conservative treatment. During hospitalization 22 patients died and 49 were discharged with a major amputation. On multivariate analysis, the only factor associated with the risk of amputation was gangrenous lesions (OR 2.45; IC95%1.22-4.92). Factors associated with mortality were the presence of chronic renal failure (OR 3.38; IC95%1.36-8.39) and previous CLI (OR 0.20; IC95%0.05-0.89). At discharge, 59%received lipid lowering drugs, 70%blood-pressure lowering medications and 85%antiplatelet drugs.

Conclusion

CLI patients attended in Spanish vascular surgery departments have a low amputation rate and a low hospital mortality. However, and due to their high cardiovascular risk, it is necessary to improve the prescription rate of evidence-based cardiovascular prevention therapies at discharge.