Outcomes and Risk Factors Associated with Major Amputation in Patients with Acute Lower Limb Ischemia Undergoing Revascularization
DOI:
https://doi.org/10.64387/tjs.2026.277145Keywords:
Acute limb ischemia, Revascularization, Thrombo-embolectomy, Bypass, Risk factorsAbstract
Objective: To identify outcomes and risk factors associated with major amputation in patients with acute limb ischemia (ALI) who underwent revascularization.
Materials and Methods: Retrospective, cohort, risk factor study (PROGRESS II). Baseline and operative characteristics were collected from vascular surgery unit between 2017 and 2024 at Khon Kaen Hospital. Inclusion criteria were patient 18 years old and older whom diagnosed ALI underwent revascularization. Primary outcome was major amputation. Operative techniques included thromboembolectomy and surgical bypass. Risk factors for major amputation were analyzed using risk ratio regression. Statistical uncertainties were expressed as 95% two-sided confidence intervals (95% CI) in all analyses. A p-value less than 0.05 was considered statistically significant.
Results: A total of 152 patients underwent surgical revascularization for ALI. 63.5% were male. Major amputation rate was 17.1%. Mean age was 61.8 ± 16.0 years. Significant clinical characteristics associated with major amputation were onset, sepsis, and acute kidney injury (AKI). Multivariable analysis showed male sex, alcohol use, diabetic mellitus (DM), hypertension (HT), atrial fibrillation (AF), chronic kidney disease (CKD), fasciotomy, reperfusion injury, and chronic heart failure (CHF), were the significant prognostic factors for major amputation in patients with ALI who underwent revascularization.
Conclusion: In high-volume retrospective cohort study showed a significant major limb loss number with some modifiable prognostic factors. Fasciotomy may be performed to save limb, and the health literacy should be educated to get the patients suffering from ALI come to the hospital earlier.
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