Osteopenia is a Risk Factor for 2-year Postoperative Survival in Patients with Chronic Limb-Threatening Ischemia

Patients with chronic limb-threatening ischemia (CLTI) require revascularization. Current guidelines suggest careful consideration of patient risks prior to selecting the most appropriate approach to treatment. This study aimed to determine the impact of osteopenia as a prognostic factor in patients with CLTI.

This single-center retrospective study included patients with CLTI who underwent revascularization. The primary endpoint was 2-year postoperative survival. The secondary endpoint was 2-year amputation-free survival and limb salvage rates.

Of 273 patients, 177 (64.8%) had osteopenia. Patients with osteopenia had a significantly lower 2-year postoperative survival than patients without osteopenia (67.9% vs. 80.9%, P = 0.0348). Multivariate analysis revealed that age (hazard ratio (HR): 1.06, 95% confidence interval (CI): 1.03-1.10, P = 0.0003), end-stage renal disease on hemodialysis (HR: 3.79, 95% CI: 2.22-6.47, P < 0.0001), sarcopenia (HR: 1.77, 95% CI: 1.02-3.08, P = 0.0421), and osteopenia (HR: 1.77, 95% CI: 1.02-3.08, P = 0.0440) were independent prognostic factors for 2-year postoperative survival in patients with CLTI. In particular, patients with osteopenia had a significantly lower 2-year survival rate after revascularization than patients without osteopenia (67.9% vs. 80.9%, P = 0.0348).

Osteopenia is an independent prognostic risk factor in patients with CLTI and should be considered when choosing procedures, particularly as the 2-year survival rate of patients with osteopenia is low.