LONG-TERM MORTALITY AND ITS PREDICTORS IN PATIENTS WITH CRITICAL LEG ISCHEMIA

Objective: To assess the predictivity of predefined variables with res pect to long-term mortality in a cohort of patients with chronic criti cal leg ischaemia (CLI). Design: Prospective observational study. Meth ods: Census offices were asked to release information or survival or d eath status of 574 patients with CLI 2 years after their recruitment i n the study.Results: Of 522 patients with available information, 165 ( 31.6%) died within 2 years of hospital admission, mostly from vascular causes as expected. Among the variables considered, male sex, current smoking, arterial hypertension, diabetes mellitus, hypercholesterolae mia, obesity, history of myocardial infarction and low ankle systolic pressure showed no univariate association with mortality. The multivar iate analysis also excluded revascularisation procedures and the Fonta ine stage as prognostic factors in terms of mortality. Besides age gre ater than or equal to 70 years (relative risk, RR 1.94; 95% confidence interval (CI) 1.37-2.70), only a history of stroke (RR 1.82; 95% CI 1 .19-2.79) and major amputation (RR 1.90; 95% CI 1.30-2.80) were signif icantly associated with mortality. Conclusions: CLI is a clinical cond ition of such severity that most of the recognised cardiovascular risk factors cannot further influence the fate of the patients, one-third of whom die within 2 years.