[General outcome in critical limb ischemia in patients with arterial occlusive disease (AOD)]

Recent vascular studies suggests that patients with arterial occlusive disease (AOD) and with elevated score of multiple risk factors (MRF), especially diabetes mellitus, have an increased prevalence of critical limb ischaemia, increased incidence of lower limb amputations, and an overall poor outcome of their AOD. The aim of this study is to evaluate an overall outcome of AOD, Fontaine stage III and IV, and to correlate their outcome with score of MRF.

We enrolled a group of 136 patients (99 males and 37 females), with an average of 63.7 yrs and SD 12.2 all with AOD, Fontaine stage III and IV. We divided pts in three groups--pts on medicament treatment--MT group, pts for lower limb amputation--AMP group, and pts for vascular surgery. According to their clinical stage we had group in Fontaine stage III (n-48), and Fontaine IV (n-88). We followed 9 clinical variables: age, gender, tobacco, arterial hypertension, diabetes mellitus, hyperlipidaemia, level of fibrinogen, coronary ischaemic disease and cerebrovascular disease.

In MT group we had n-91 (66.9%) with MRF score of 3.42. In Fontaine stage III we had 37 pts with MRF score of 3.89, and in Fontaine stage IV we had 54 pts with MRF score of 3.37. In AMP group we had n-23 pts (16.9%) with MRF score of 3.39, and all pts were in F IV stage. In VH group we had n-22 pts (16.1%) with MRF score of 3.1. In VH group 50% of pts were in F IV stage. In overall group (n-136) we had a significant number of Fontaine IV stage pts, p < 0.01.

We had a high risk group of patients, with mean MRF score of 3.42, 23 pts (16.9%) were referred for lower limb amputation, and 23 pts (16.9%) for vascular surgery. MRF score correlate with overall outcome of AOD, r = 0.72, p < 0.001.