PhD Scientific Days 2022

Clinical Medicine IV.

Amputation and mortality rates of patients undergoing upper or lower limb surgical embolectomy and their predictors

Előadó neve

Dr. Bérczi, Ákos

Előadó munkahelye

Heart and Vascular Center of Semmelweis University

Előadó telefonszáma

+36206701712

Előadó e-mail címe

bercziak@gmail.com

Az előadás címe

Amputation and mortality rates of patients undergoing upper or lower limb surgical embolectomy and their predictors

Szerző(k) neve és munkahelye

Ákos Bérczi1,2, Dat Tin Nguyen1,2, Hunor Sarkadi1,2, Balázs Bence Nyárádi1,2, Piroska Beneda1,2, Ádám Szőnyi1,2, Márton Philippovich1,2, Zoltán Szeberin3, Edit Dósa1,2*

1Department of Interventional Radiology, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
2Hungarian Vascular Radiology Research Group, Budapest, Hungary
3Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Budapest, Hungary

Bemutatás módja

Szóbeli

Szekció

Clinical Medicine IV.

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Purpose: To provide information on the outcomes of upper and lower limb surgical embolectomies and the factors influencing amputation and mortality.
Methods: A retrospective, single-center analysis of 347 patients (female, N=207; male, N=140; median age, 76 years [interquartile range {IQR}, 63.2–82.6 years]) with acute upper or lower limb ischemia due to embolism who underwent surgery between 2005 and 2019 was carried out. Patient demographics, comorbidities, medical history, the severity of acute limb ischemia (ALI), preoperative medication regimen, embolus localization, procedural data, in-hospital complications/adverse events and their related interventions, and 30-day mortality were reviewed in electronic medical records. Statistical analysis was performed using the Mann–Whitney U test and Fisher’s exact test; in addition, univariate and multivariate logistic regression was conducted.
Results: The embolus was localized to the upper limb in 134 patients (38.6%) and the lower limb in 213 patients (61.4%). The median length of hospital stay was 3.8 days (IQR, 2.1–6.6 days). The in-hospital major amputation rates for the upper limb, lower limb, and total patient population were 2.2%, 14.1%, and 9.5%, respectively, and the in-hospital plus 30-day mortality rates were 4.5%, 9.4%, and 7.5%, respectively. In patients with lower limb embolectomy, the predictor of in-hospital major amputation was the time between the onset of symptoms and embolectomy (OR, 1.78), while the predictor of in-hospital plus 30-day mortality was previous stroke (OR, 7.16). In the overall patient cohort, there were two predictors of in-hospital major amputation: 1) the time between the onset of symptoms and embolectomy (OR, 1.92) and 2) compartment syndrome (OR, 3.51).
Conclusion: Amputation and mortality rates after surgical embolectomies in patients with ALI are high. Patients with prolonged admission time, compartment syndrome, and history of stroke are at increased risk of limb loss or death. To avoid amputation and death, patients with ALI should undergo surgical intervention as soon as possible and receive close monitoring in the peri- and postprocedural periods.

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine

Supervisor

Dr. Dósa Edit

Publication of my abstract

I do not give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

4010

Start

15:30

End

15:45

Authors (legacy)

Ákos Bérczi1,2, Dat Tin Nguyen1,2, Hunor Sarkadi1,2, Balázs Bence Nyárádi1,2, Piroska Beneda1,2, Ádám Szőnyi1,2, Márton Philippovich1,2, Zoltán Szeberin3, Edit Dósa1,2*

1Department of Interventional Radiology, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
2Hungarian Vascular Radiology Research Group, Budapest, Hungary
3Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Budapest, Hungary