Survival in patients with chronic lower extremity ischemia: A risk factor analysis

This is a prospective cohort comparison study aiming to determine the morta lity of patients with peripheral arterial occlusive disease (PAOD) and iden tify the risk factors affecting their survival. Data regarding demographic and biochemical risk factors, and lower limb disease severity classified by vascular laboratory criteria were collected prospectively from 665 consecu tive patients presenting with symptoms of peripheral arterial occlusive dis ease. The effect of patient and disease risk factors on survival was analyz ed by the life-table method and independent significant variables examined by a multivariate Cox regression model. The cumulative survival for all pat ients at 1, 3, and 5 years were 86.1, 71.2, and 55.8%, respectively, with a median survival of 72.2 months. Female sex, age, smoking, heart disease, r enal disease, respiratory disease, stroke, critical ischemia, lowest ankleb rachial index, no vascular reconstruction, and major amputation were associ ated with higher mortality. Lipid and biochemical variables were not signif icant determinants. Using multivariate Cox regression, age (>70), disease s everity, anklebrachial index (<0.5), no vascular reconstruction, diabetes m ellitus, and renal and cardiorespiratory diseases were identified as indepe ndent risk factors affecting patient survival. The survival of patients wit h PAOD is poor compared with the general population. Significant patient-re lated variables were largely coexisting diseases and advanced age, whereas the other risk factors for atherosclerosis are less influential. Disease se verity may bear a direct relationship to mortality, and patients with criti cal ischemia have the worst prognosis. Early disease detection and timely v ascular reconstruction may lead to an improvement in overall survival. DOI: 10.1007/s100169910028.