Acute ischemia of the extremities in a metropolitan area during one year

All acute extremity ischemias during one year (1980) in the greater Stockholm area (population 1.5 million) were evaluated. One hundred and thirty eight cases were found. The incidence figures varied from 0.4/100,000 in the age group 20 to 30 years to 182/100,000 in the ages above 90 years. 81% of the cases were classified as emboli and 19% as acute thrombosis. Over all mortality was 19.5%. In the embolism group mortality was 21%, amputation rate 28% and limb salvage rate 51%. Limb salvage rate was significantly higher in patients receiving heparin therapy (61%) as compared to those who received no heparin (32%). Delay of treatment also caused an increase in amputation rate. Patients with acute thrombosis had a lower mortality (12%) and an amputation rate of 42%. It is concluded that the results of acute extremity ischemia may be less favourable than previously reported when results from institutions not specialised in vascular surgery are also included. Among other possible factors explaining the high amputation rate may be the proportion of older patients.