Acute limb ischemia in the elderly: Determining the mortality factors

The study aims to identify factors associated with mortality in elderly patients undergoing surgery for acute limb ischemia.

Between October 2010 and January 2024, a total of 205 patients (106 males, 99 females; mean age: 77.7±8.0 years; range, 65 to 98 years) who underwent embolectomy for acute limb ischemia were retrospectively analyzed. Postoperative mortality and one-year mortality were designated as primary outcome measures. Multiple regression analyses were performed for variables related to postoperative mortality, and cut-off values for numeric variables were determined. The Kaplan-Meier survival analyses were performed using one-year mortality data.

Postoperative mortality rate was 35.1% and oneyear mortality rate was 56.6%. A total of 52.8% of the patients who died postoperatively were functionally dependent and 72.2% had no history of atrial fibrillation. Multivariate analysis revealed that a neutrophil-to-lymphocyte ratio above 5.91 increased mortality by 9.1 times, functional dependency by 7.3 times, and absence of a history of atrial fibrillation by 3.3 times. Functional dependency, absence of atrial fibrillation, and neutrophil-to-lymphocyte ratio greater than 5.85 negatively affected one-year mortality.

Our study results indicate that absence of atrial fibrillation, functional dependency, and neutrophil-to-lymphocyte ratio can be used to predict postoperative mortality.