METHODS: We conducted an observational retrospective single-center cohort study. We evaluated patients with PAD that primarily underwent ER, OR, minor, and major amputations in a single center from 2005 to 2020. The patients were then subdivided according to the type of intervention (OR versus ER), and stratified according to the International Classification of Diseases 9 code reported in the operating documents and to the year intervention. Mortality, minor, and major amputation rates occurring at 30 days, 2 years, and 5 years after the first intervention were evaluated as primary outcomes and compared between patient groups in both stratifications. Moreover, Kaplan-Maier curves were analyzed for these outcomes.
RESULTS: One thousand four hundred ninety two patients (67.0% males) with PAD were evaluated. Their clinical presentations were intermittent claudication in 51.4% of cases, rest pain in 16.8%, ulcers in 10.3%, and gangrene in 21.5%. Nine hundred ninety seven (66.8%) underwent OR and 495 (33.2%) ER as first intervention for PAD. No statistical differences were observed in terms of mortality in the 2 groups (OR versus ER, P = 1,000, P = 0.357, and P = 0.688 at 30 days, 2 years, and 5 years, respectively). The rate of minor amputations was significantly higher (P < 0.012, P < 0.002, and P < 0.007 at 30 days, 2 years, and 5 years, respectively) for ER group in any of the observed follow-up periods. Also, we have observed that OR and ER do not have any significant short-term and medium-term major amputation rate differences.
CONCLUSIONS: In our experience, the impact of ER does not significantly change short-term and mid-term major outcomes in patients with PAD.
方法:观察性回顾性单中心队列研究。
方法:我们评估了主要接受ER、OR,从2005年到2020年,在一个中心进行轻微和重大截肢。然后根据干预类型(ORvsER)对患者进行细分,并根据操作文件中报告的ICD-9代码和年度干预进行分层。死亡率,发生在30天的轻微和主要截肢率,首次干预后2年和5年被评估为主要结果,并在两个分层中的患者组之间进行比较。此外,分析这些结果的Kaplan-Maier(KM)曲线。
结果:评估了1492例PAD患者(67.0%为男性)。他们的临床表现为51.4%的间歇性跛行,休息疼痛16.8%,溃疡占10.3%,坏疽占21.5%。997(66.8%)接受OR和495(33.2%)ER作为PAD的首次干预。两组死亡率无统计学差异(ORvsER,p=1.000,p=0.357,p=0.688,30天,分别为2年和5年)。轻微截肢率明显较高(p<.012,p<.002,p<.007,30天,在任何观察到的随访期内,ER组分别为2年和5年)。此外,我们观察到OR和ER在短期和中期重大截肢率方面没有任何显著差异.
结论:根据我们的经验,ER的影响不会显著改变PAD患者的短期和中期主要结局.