A 10-year experience of managing acute limb ischaemia in India.
BACKGROUND
Acute limb ischaemia is threatening to both limb and life. There is little information about this disease entity from India.


METHODS
We did a retrospective analysis of the clinical profile of patients presenting with non-traumatic acute limb ischaemia to our department (a tertiary care centre in India) from January 1998 to December 2007. The demography, risk factors, time taken to present to the emergency from the onset of symptoms, time taken to administer the first dose of heparin upon arrival to the emergency, primary interventions and outcomes in terms of amputation rates and in-hospital mortality were studied.


RESULTS
The mean (SD) age of the 84 patients was 48.9 (14.3) years. Only one patient died (1.2%) and 24 patients had an amputation (28.6%). Among the predisposing risk factors a significant association was found between smoking and the rate of amputation. Early presentation to emergency and early administration of heparin was associated with lower amputation rates though this did not achieve statistical significance.


CONCLUSIONS
Acute limb ischaemia is a catastrophic event. Smoking is a risk factor associated with poorer outcomes. Early arrival to the emergency and early administration of heparin was associated with lower amputation rates.
Turel
Mazda
M
Department of Vascular Surgery (General Surgery Unit II), Christian Medical College, Vellore 632004, Tamil Nadu, India. mazdaturel@gmail.com
Kumar
Prabhu Prem
PP
Stephen
Edwin
E
Agarwal
Sunil
S
D000208:Acute Disease; D000671:Amputation, Surgical; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007194:India; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000601:surgery; D012307:Risk Factors; D013997:Time Factors
D000925:Anticoagulants; D006493:Heparin