Abstract：
BACKGROUND: To examine the influence of liver function on patients with chronic limb-threatening ischemia (CLTI), we classified patients with CLTI after revascularization according to their modified albumin-bilirubin (ALBI) grades.
METHODS: We retrospectively analyzed single-center data of patients who underwent revascularization for CLTI between 2015 and 2020. Patients were classified with ALBI grades 1, 2a, and 2b and 3 according to the ALBI score, which was calculated, based on serum albumin and total bilirubin levels. The endpoints were the 2-year amputation-free survival (AFS) and 1-year wound healing rates.
RESULTS: We included 190 limbs in 148 patients, and 50, 54, and 86 cases were assigned as grade 1, 2a, and 2b and 3, respectively. The 2-year AFS rates for the grade 1, 2a, and 2b and 3 groups were 79 ± 6%, 66% ± 7%, and 45 ± 6%, respectively (P < 0.01). One-year cumulative wound healing rates for grade 1, 2a, and 2b and 3 groups were 68 ± 7%, 69% ± 6%, and 48% ± 5%, respectively (P = 0.01). Multivariate Cox proportional hazard analyses identified age (≥75 years), dependent ambulatory status, and modified ALBI grades 2b and 3 compared with grades 1 and 2a as significant independent predictors of AFS. The dependent ambulatory status and Wound, Ischemia, and foot Infection classification stage 4 were significant negative predictors of wound healing.
CONCLUSIONS: Many patients with CLTI had high modified ALBI grades, and impaired liver function classified as modified ALBI grade 2b and 3 is a robust negative predictor of AFS.
METHODS: We retrospectively analyzed single-center data of patients who underwent revascularization for CLTI between 2015 and 2020. Patients were classified with ALBI grades 1, 2a, and 2b and 3 according to the ALBI score, which was calculated, based on serum albumin and total bilirubin levels. The endpoints were the 2-year amputation-free survival (AFS) and 1-year wound healing rates.
RESULTS: We included 190 limbs in 148 patients, and 50, 54, and 86 cases were assigned as grade 1, 2a, and 2b and 3, respectively. The 2-year AFS rates for the grade 1, 2a, and 2b and 3 groups were 79 ± 6%, 66% ± 7%, and 45 ± 6%, respectively (P < 0.01). One-year cumulative wound healing rates for grade 1, 2a, and 2b and 3 groups were 68 ± 7%, 69% ± 6%, and 48% ± 5%, respectively (P = 0.01). Multivariate Cox proportional hazard analyses identified age (≥75 years), dependent ambulatory status, and modified ALBI grades 2b and 3 compared with grades 1 and 2a as significant independent predictors of AFS. The dependent ambulatory status and Wound, Ischemia, and foot Infection classification stage 4 were significant negative predictors of wound healing.
CONCLUSIONS: Many patients with CLTI had high modified ALBI grades, and impaired liver function classified as modified ALBI grade 2b and 3 is a robust negative predictor of AFS.
摘要：
目的：研究肝功能对慢性威胁肢体缺血（CLTI）患者的影响，我们根据改良ALBI分级对血运重建后的CLTI患者进行了分类.
方法：我们回顾性分析了2015年至2020年间接受CLTI血运重建的患者的单中心数据。患者被分类为改良白蛋白-胆红素（ALBI）等级1，2a，根据ALBI评分和2b&3，这是根据血清白蛋白和总胆红素水平计算的。终点是两年无截肢生存率（AFS）和一年伤口愈合率。
结果：我们包括148例患者的190条肢体，50、54和86例被分配为1、2a级，和2b&3。1、2a年级的两年AFS费率，2b&3组为79±6%，66%±7%,和45±6%，分别为(P<0.01)。1、2a级的一年累计伤口愈合率，2b&3组为68±7%，69%±6%,48%±5%，分别为(P=0.01)。多变量Cox比例风险分析确定年龄(≥75岁)，依赖的动态状态，与1级和2a级相比，修正的ALBI等级2b和3级是AFS的显著独立预测因子。依赖性卧床状态和WIfI第4阶段是伤口愈合的显着负预测因子。
结论：许多CLTI患者的ALBI改良分级较高，被分类为改良ALBI2b级或3级的肝功能受损是无截肢生存率的可靠阴性预测指标。
方法：我们回顾性分析了2015年至2020年间接受CLTI血运重建的患者的单中心数据。患者被分类为改良白蛋白-胆红素（ALBI）等级1，2a，根据ALBI评分和2b&3，这是根据血清白蛋白和总胆红素水平计算的。终点是两年无截肢生存率（AFS）和一年伤口愈合率。
结果：我们包括148例患者的190条肢体，50、54和86例被分配为1、2a级，和2b&3。1、2a年级的两年AFS费率，2b&3组为79±6%，66%±7%,和45±6%，分别为(P<0.01)。1、2a级的一年累计伤口愈合率，2b&3组为68±7%，69%±6%,48%±5%，分别为(P=0.01)。多变量Cox比例风险分析确定年龄(≥75岁)，依赖的动态状态，与1级和2a级相比，修正的ALBI等级2b和3级是AFS的显著独立预测因子。依赖性卧床状态和WIfI第4阶段是伤口愈合的显着负预测因子。
结论：许多CLTI患者的ALBI改良分级较高，被分类为改良ALBI2b级或3级的肝功能受损是无截肢生存率的可靠阴性预测指标。
