Epidemiological analysis of critical lower limb ischemia in a terciary hospital.

Abstract

Introduction: acute limb ischemia (ALI) is any sudden decrease or worsening in limb perfusion that threatens its viability. Objective: to analyze the epidemiological characteristics of patients with ALI in a terciary hospital. Methods: retrospective and cross-sectional study, with review of medical records of hospitalizations due to ALI in lower limbs occurring from 2013 to 2016. The following variables were analyzed: age, sex, comorbidities (diabetes melitus, systemic arterial hypertension, 

chronic heart diseases), smoking, treatment and in-hospital outcomes. Chi-square test was used to compare groups. Results: fifty-one patients (52.9% male) were studied, with average age of 68y in both sexes. Among comorbidities, 78.4% were hypertensive, 66.7% were smokers, 35.3% had atrial fibrillation, and 27.4% were diabetics. Sixteen cases evolved to amputation, of which 14 were major amputations. There was no statistically significant difference on the comorbidities between the groups that evolved or not to amputation. However, patients classified as Rutherford III had higher rates of amputation (p=0.0043). The most common surgical procedure was thromboembolectomy, performed in 39.7%, followed by endovascular revascularization, in 12.7%. Conclusion: endovascular treatment is still poorly indicated in ALI, while conventional surgery is still the first-line therapy. Patients with ALI have higher prevalence of atherosclerosis risk factors, although they are not directly related to limb loss.