DIFFERENCES BETWEEN ACUTE NONTRAUMATIC UPPER AND LOWER-EXTREMITY ISCHEMIA

The aim of this study was to analyze the differences in natural periop erative history and risk factors in patients with acute upper and lowe r extremity ischemia. According to the national vascular registry (FIN NVASC) for the period January 1991-November 1992, 599 patients were tr eated in Finland for acute extremity ischemia. Ninety (15%) patients w ere treated for acute upper limb ischemia and 509 (85%) for acute lowe r limb ischemia. Upper extremity ischemia was more common in women (P < 0.05). patients with acute upper limb ischemia were older, 77.1 vers us 73.2 years (P < 0.001). The embolus/thrombosis ratio in patients wi th acute upper extremity ischemia was 90/10% as against 62.5/37.5% in patients with acute lower extremity ischemia (P < 0.001). Smoking was more common in patients with acute lower extremity ischemia (P < 0.05) . No other difference was noted in risk factors between the upper and lower extremity groups. No amputation of an upper limb was done. Morta lity after acute upper extremity ischemia was 5.6% and after acute low er extremity ischemia 12.8% (p=0.07). The authors conclude that acute upper limb ischemia was most often caused by embolism and these patien ts were more often older and women as compared with patients with acut e lower limb ischemia. Upper limb ischemia was also more common in the right upper limb. No upper limb amputation was done; however, mortali ty among these patients was not significantly lower.