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Predicting Amputation Rates in Acute Limb Ischemia: Is the Neutrophil-Lymphocyte Ratio a Reliable Indicator?
Mehmet Emir Erol1, İsa Civelek1, Sertan Ozyalcin1
1Department of Cardiovascular Surgery, Ankara Etlik City Hospital, Ankara, TUR.
Cureus
|April 30, 2024
Summary
Timely intervention is crucial for acute limb ischemia (ALI) patients to prevent amputation. Longer symptom-to-door times significantly increase amputation risk, while biochemical markers show no impact.
Area of Science:
- Vascular Surgery
- Clinical Medicine
- Biochemistry
Background:
- Acute limb ischemia (ALI) is a critical condition requiring prompt management.
- Amputation is a potential severe outcome in ALI patients.
- Understanding factors influencing amputation is vital for improving patient outcomes.
Purpose of the Study:
- To investigate amputation causes in ALI patients.
- To assess the role of biochemical parameters in ALI-related amputations.
- To identify key predictors for amputation in ALI.
Main Methods:
- Retrospective analysis of 374 ALI patients (Jan 2012-Jan 2022).
- Inclusion criteria: ALI due to atherosclerosis or atrial fibrillation.
- Exclusion criteria: ALI from trauma, iatrogenic causes, or aneurysms.
Main Results:
- Amputation was required in 7.95% of ALI patients.
- Symptom-to-door time was the primary predictor of amputation.
- Each hour delay increased amputation risk by 1.3 times (OR: 1.289, CI: 1.079-1.540).
- Neutrophil-to-lymphocyte ratio and other hematological parameters did not influence amputation risk.
Conclusions:
- Symptom-to-door time is the critical factor determining amputation in ALI.
- Biochemical and hematological parameters do not significantly affect amputation rates in ALI patients.
- Emphasizes the importance of rapid diagnosis and treatment for ALI.
