Patient survival and limb prognosis after arterial embolectomy.
Mortality and morbidity after arterial thromboembolectomy were studied in 202 patients. Factors affecting reoperation and survival were identified according to Cox's proportional hazards model. 30-day mortality was 26% and amputation rate 18.5%. NYHA classification was the most important predictor for survival; class 3-4 had a 3.35 times higher death rate than class 1-2. An age greater than 75 years increased the death rate by 2.35 times and the presence of ischaemic heart or peripheral arteriosclerotic disease increased it by 1.69 and 1.65 times, respectively. Symptoms less than or equal to 1 day in duration were associated with a death rate 1.53 times higher than for a longer duration. Reoperation rate was 2.15 times greater in the absence of atrial dysrhythmias. The amputation rate was 3.79 times higher in NYHA class 3-4 than in class 1-2, and 2.47 times higher in the presence of peripheral arteriosclerotic disease. Apparently, thrombosis rather than recurrent embolism is the most important cause of reoperation and amputation. The severity of pre-existing cardiopulmonary disease largely determines prognosis regardless of the severity of the superimposed acute occlusion.
Dregelid
E B
EB
Department of Surgery, University of Bergen, Haukeland Hospital, Norway.
Stangeland
L B
LB
Eide
G E
GE
Trippestad
A
A
D000368:Aged; D000671:Amputation, Surgical; D001132:Arm / Q000098:blood supply; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D012008:Recurrence; D012086:Reoperation; D013923:Thromboembolism / Q000150:complications / Q000401:mortality* / Q000601:surgery*