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SVS WIfI score as a predictor of amputation after onset of CLI: Validation in an Irish tertiary vascular unit

Zeeshan Ahmed1, Muhammad Zeeshan Raza1, Amy P Worrall1

  • 1Department of Vascular Surgery, Beaumont Hospital, Dublin 9, Ireland.

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
|March 26, 2022
PubMed

Insights

The Society for Vascular Surgery Wound, Ischemia, and Foot Infection (SVS WIfI) score effectively predicts amputation risk in diabetic patients with critical limb ischemia (CLI). Higher scores indicate a greater need for amputation over revascularization.

Area of Science:

  • Vascular Surgery
  • Diabetic Limb Complications
  • Clinical Outcomes Prediction

Background:

  • Critical limb ischemia (CLI) in diabetics involves non-healing ulcers or rest pain with low ankle pressure.
  • The SVS WIfI system stratifies CLI based on wound, ischemia, and infection.
  • This stratification guides management and predicts prognosis.

Purpose of the Study:

  • To evaluate the SVS WIfI scoring system's ability to predict early revascularization versus amputation in CLI patients.
  • To correlate composite WIfI scores with the likelihood of limb salvage or loss.

Main Methods:

  • Retrospective observational study of 87 CLI patients admitted over two years.
  • Calculation of the composite SVS WIfI score for each patient.
  • Identification of WIfI categories and correlation with amputation outcomes (major/minor).

Main Results:

  • 40% of patients (35/87) required major amputation.
  • Patients undergoing major amputation had a higher median initial WIfI score (7) compared to minor amputation (5).
  • Vascular intervention was part of care for 83% of major amputation patients.

Conclusions:

  • The SVS WIfI score is a reliable predictor of amputation necessity in CLI.
  • Early utilization of the WIfI scoring system is recommended for managing infected ischemic limbs.
Abstract

Keywords:
AmputationDiabetic footEndovascularSVS Wifi score

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