The efficacy of a multidisciplinary team approach in critical limb ischemia View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-04-22

AUTHORS

Hiroshi Suzuki, Atsuo Maeda, Hideyuki Maezawa, Tomoichiro Togo, Hitoshi Nemoto, Yoshiaki Kasai, Yoshinori Ito, Tokio Nakada, Hirohiko Sueki, Aya Mizukami, Mamiko Takayasu, Kenji Iwaku, Susumu Takeuchi, Hiroyuki Tanaka, Yoshitaka Iso

ABSTRACT

The aim of the present study was to clarify the characteristics of Japanese critical limb ischemia (CLI) patients and analyze the rates of real-world mortality and amputation-free survival (AFS) in all patients with Fontaine stage IV CLI who were treated with/without revascularization therapy by an intra-hospital multidisciplinary care team. All consecutive patients who presented with CLI at Showa University Fujigaoka Hospital between April 2008 and March 2014 were prospectively registered. The intra-hospital committee consisted of cardiologists, plastic surgeons, dermatologists, diabetologists, nephrologists, cardiovascular surgeons, and vascular technologists. The primary endpoint of this study was all-cause mortality and AFS during the follow-up period. The present study included 145 patients with Fontaine stage IV CLI. The mean age was 76.5 ± 10.2 years. The all-cause mortality rate during the follow-up period (15.5 ± 16.1 months) was 21.4 %. The AFS rate during the follow-up period (14.1 ± 16.4 months) was 58.6 %. A multivariate Cox proportional hazards regression analysis found that age >75 years and hemodialysis were significantly associated with all-cause mortality; and that age >75 years, Rutherford 6, and wound infection were significantly associated with AFS. A multidisciplinary approach and comprehensive care may improve the outcomes and optimize the collaborative treatment of CLI patients. However, all-cause mortality remained high in patients with Fontaine stage IV CLI and early referral to a hospital that can provide specialized treatment for CLI, before the occurrence of major tissue loss or infection, is necessary to avoid primary amputation. More... »

PAGES

55-60

Journal

TITLE

Heart and Vessels

ISSUE

1

VOLUME

32

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00380-016-0840-z

DOI

http://dx.doi.org/10.1007/s00380-016-0840-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1044797946

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27106919


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30 schema:description The aim of the present study was to clarify the characteristics of Japanese critical limb ischemia (CLI) patients and analyze the rates of real-world mortality and amputation-free survival (AFS) in all patients with Fontaine stage IV CLI who were treated with/without revascularization therapy by an intra-hospital multidisciplinary care team. All consecutive patients who presented with CLI at Showa University Fujigaoka Hospital between April 2008 and March 2014 were prospectively registered. The intra-hospital committee consisted of cardiologists, plastic surgeons, dermatologists, diabetologists, nephrologists, cardiovascular surgeons, and vascular technologists. The primary endpoint of this study was all-cause mortality and AFS during the follow-up period. The present study included 145 patients with Fontaine stage IV CLI. The mean age was 76.5 ± 10.2 years. The all-cause mortality rate during the follow-up period (15.5 ± 16.1 months) was 21.4 %. The AFS rate during the follow-up period (14.1 ± 16.4 months) was 58.6 %. A multivariate Cox proportional hazards regression analysis found that age >75 years and hemodialysis were significantly associated with all-cause mortality; and that age >75 years, Rutherford 6, and wound infection were significantly associated with AFS. A multidisciplinary approach and comprehensive care may improve the outcomes and optimize the collaborative treatment of CLI patients. However, all-cause mortality remained high in patients with Fontaine stage IV CLI and early referral to a hospital that can provide specialized treatment for CLI, before the occurrence of major tissue loss or infection, is necessary to avoid primary amputation.
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37 CLI
38 CLI patients
39 Committee
40 Cox proportional hazards regression analysis
41 Fujigaoka Hospital
42 Rutherford 6
43 Showa University Fujigaoka Hospital
44 age
45 aim
46 amputation
47 amputation-free survival
48 analysis
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50 cardiologists
51 cardiovascular surgeons
52 care
53 care team
54 cause mortality
55 cause mortality rates
56 characteristics
57 collaborative treatment
58 comprehensive care
59 consecutive patients
60 critical limb ischemia
61 critical limb ischemia patients
62 dermatologists
63 diabetologists
64 early referral
65 efficacy
66 endpoint
67 hazards regression analysis
68 hemodialysis
69 hospital
70 infection
71 ischemia
72 ischemia patients
73 limb ischemia
74 loss
75 major tissue loss
76 mean age
77 mortality
78 mortality rate
79 multidisciplinary approach
80 multidisciplinary care team
81 multidisciplinary team approach
82 multivariate Cox proportional hazards regression analysis
83 nephrologists
84 occurrence
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86 patients
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92 proportional hazards regression analysis
93 rate
94 referral
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