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Poor outcome in patients aged over 80 with limb-threatening ischaemia
B Davies1, B P Heather, J J Earnshaw
1Gloucestershire Royal Hospital, Gloucester, UK.
Cardiovascular Surgery (London, England)
|March 12, 1999
Summary
Elderly patients over 80 with limb-threatening ischemia who received active treatment had better outcomes than those not treated. This study highlights the need for unbiased reporting on all patients with leg ischemia.
Area of Science:
- Vascular Surgery
- Geriatric Medicine
- Ischemia Research
Background:
- Limb-threatening ischemia disproportionately affects elderly patients.
- Outcomes for elderly patients with critical limb ischemia are often poorly documented.
- Selection bias in reporting can skew understanding of treatment efficacy.
Purpose of the Study:
- To evaluate treatment outcomes in patients over 80 with limb-threatening ischemia.
- To compare outcomes between actively treated and untreated elderly patients.
- To advocate for comprehensive reporting in clinical studies of leg ischemia.
Main Methods:
- Retrospective case-note review of 108 patients with 131 episodes of leg ischemia.
- Analysis of treatment strategies including limb salvage, amputation, and mortality.
- Data collected from a vascular unit between 1992 and 1996.
Main Results:
- Actively treated patients (73 episodes) showed a 75% limb salvage rate, 4% amputation, and 21% mortality.
- Untreated patients (58 episodes) had significantly worse outcomes: 19% limb salvage, 50% amputation, and 31% mortality.
- Elderly patients not selected for active treatment experienced very poor outcomes.
Conclusions:
- Elderly patients with limb-threatening ischemia have vastly different outcomes depending on active treatment selection.
- Clinical reports must include both treated and untreated patient groups to prevent selection bias.
- Future research should investigate optimal selection criteria and explore alternative therapies for this demographic.