Neutrophil count and amputation in critical limb ischaemia.
BACKGROUND
The white blood cell count (WCC) is known to be predictive of cardiac and cerebral vascular events. No one has yet investigated this in critical limb ischaemia (CLI).


METHODS
Baseline WCC was examined in relation to lower limb amputation 6 months after a 4 week treatment period with i.v. placebo or i.v. taprostene in 366 patients with CLI.


RESULTS
The WCC was related to a significant increase in amputation, relative risk 1.6 (p=0.001, 95% CI: 1.2-2.0) in CLI patients with WCC > or =9x10(9)/l vs patients with WCC <9x10(9)/l. Its association with disabling amputation persisted on logistic regression analyses which included cigarette smoking as a variable and also treatment group (p<0.001). The WCC is therefore an easily measurable prognostic variable in CLI.


CONCLUSIONS
The white blood cell may promote intractable tissue ischaemia by capillary plugging and/or release of toxic chemicals and may have distinct effects on tissue viability.
Belch
J J
JJ
University Department of Medicine, Ninewells Hospital, Dundee, Scotland.
Söhngen
M
M
Robb
R
R
Voleske
P
P
Söhngen
W
W
D000671:Amputation, Surgical; D002317:Cardiovascular Agents / Q000627:therapeutic use; D004311:Double-Blind Method; D011464:Epoprostenol / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D007958:Leukocyte Count / Q000187:drug effects; D016015:Logistic Models; D008297:Male; D009504:Neutrophils / Q000166:cytology*; D010919:Placebos; D016037:Single-Blind Method; D012907:Smoking
D002317:Cardiovascular Agents; D010919:Placebos; C039188:taprostene; D011464:Epoprostenol