title: A 1 year prospective study of management and outcome of patients presenting with critical lower limb ischaemia.
abstract: OBJECTIVE
  to determine management of patients with critical lower limb ischaemia (CLI) from first presentation to investigation and treatment.
  
  
  METHODS
  prospective study of critical ischaemia patients.
  
  
  METHODS
  one-year prospective survey (May 2000-May 2001). Follow-up 3-15 months.
  
  
  RESULTS
  some 873 arterial cases presented, 134 patients had CLI. Of the latter 49% were men, 30% diabetic, the median age was 81 years. Only 15 (24%) of 62 cases were referred to outpatients as urgent. Patients waited a median of 25 days (range 1-100) to be seen in outpatients, and had symptoms for a median of 8 weeks. Treatment was conservative for 70 patients, and 11 primary amputations, six secondary amputations, and 62 revascularisation procedures (34 operative, 28 percutaneous transluminal angioplasty) were performed. At follow-up (3-15 months, median 9 months), rates of major amputation and death were 12 and 27% respectively. Significantly more diabetics underwent major amputation (p < 0.02) than non diabetics. Patients presenting with ulceration or gangrene were at greater risk of death than those with rest pain alone (p < 0.01).
  
  
  CONCLUSIONS
  patients with CLI often have symptoms for many weeks before being seen by a specialist, and 76% are referred as non-urgent cases. This compares with patients with suspected malignant disease in the U.K. who are required to be seen within 2 weeks.
authors.affiliation: Department of Vascular Surgery, Royal Berkshire Hospital, London Road, Reading, RG1 5AN, U.K.
authors.forename: C M H
authors.initials: CM
authors.lastname: Bailey
authors.forename: S
authors.initials: S
authors.lastname: Saha
authors.forename: T R
authors.initials: TR
authors.lastname: Magee
authors.forename: R B
authors.initials: RB
authors.lastname: Galland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D023821:Limb Salvage / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D012017:Referral and Consultation; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014850:Waiting Lists; D016526:Workload