Perioperative outcome of acute lower limb ischaemia on the basis of the national vascular registry. The Finnvasc Study Group.
OBJECTIVE
To determine the mortality and limb salvage rate in acute lower limb ischaemia and compare the risk factors and outcome after acute embolic and thrombotic peripheral arterial occlusion.


METHODS
Retrospective, multicentre clinical study.


METHODS
24 Departments of Surgery in Finland.


METHODS
509 patients treated for acute lower limb ischaemia 1991-1992 as recorded in the Finnish national vascular registry (FINNVASC).


METHODS
Major amputation and death.


RESULTS
Previous major amputation or vascular surgery and smoking were found to be risk factors in patients with acute thrombosis (p < 0.001). The overall amputation rate was 16% during the postoperative period. The amputation rate in patients with acute thrombosis was 26% and in those with embolism 10% (p < 0.001). Overall mortality was 13%, in patients with thrombosis 16% and 11% in patients with embolism (p = 0.07). In a separate analysis of patients with acute thrombosis, major amputation was more common after thromboembolectomy than after reconstruction (p = 0.007).


CONCLUSIONS
The rate of major amputations and mortality were higher in acute thrombosis. The high amputation rate in this group was particularly associated with the need for reoperations and thromboembolectomy rather than reconstruction.
Kuukasjärvi
P
P
Department of Surgery, Central Hospital of Central Finland, Jyväskylä.
Salenius
J P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D001157:Arterial Occlusive Diseases / Q000401:mortality / Q000601:surgery*; D002423:Cause of Death; D003431:Cross-Cultural Comparison; D004617:Embolism / Q000401:mortality / Q000601:surgery*; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000401:mortality / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D012042:Registries / Q000706:statistics & numerical data*; D012086:Reoperation; D012307:Risk Factors; D015996:Survival Rate; D013927:Thrombosis / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome