Acute limb ischemia in the elderly: Determining the mortality factors

Area of Science:

• Vascular Surgery
• Geriatric Medicine
• Critical Care Medicine

Background:

• Acute limb ischemia (ALI) poses significant mortality risks in elderly surgical patients.
• Identifying predictive factors for mortality is essential for improving patient outcomes.

Purpose of the Study:

• To identify factors associated with postoperative and one-year mortality in elderly patients undergoing surgery for ALI.
• To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR), functional dependency, and atrial fibrillation history.

Main Methods:

• Retrospective analysis of 205 patients (mean age 77.7 years) who underwent embolectomy for ALI.
• Multivariate regression and Kaplan-Meier survival analyses were used to assess mortality predictors.
• Cut-off values for numeric variables were determined.

Main Results:

• Postoperative and one-year mortality rates were 35.1% and 56.6%, respectively.
• Functional dependency (OR 7.3), absence of atrial fibrillation (OR 3.3), and NLR > 5.91 (OR 9.1) were significant predictors of postoperative mortality.
• Functional dependency, absence of atrial fibrillation, and NLR > 5.85 negatively impacted one-year survival.

Conclusions:

• Absence of atrial fibrillation, functional dependency, and elevated NLR are significant predictors of mortality in elderly ALI patients.
• These factors can aid in risk stratification and clinical decision-making for ALI management.
• Further research may explore targeted interventions based on these identified risk factors.