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The aim of this retrospective study was to design a new scoring system for prediction of wound healing after endovascular treatment (EVT) in case of critical limb ischemia (CLI).
We obtained the data for 147 patients (174 limbs) who received EVT for CLI classified as Ruthrford class 5 or 6 from April 2007 to October 2011. A total of 191 separate wounds were treated in these patients. Univariate analysis was performed with each indicator related to wound healing. Indicators that were shown to be significant in univariate analysis (p < 0.05) were included in multiple logistic regression analysis in order to develop an odds ratio for wound healing. The item scores were transformed from regression coefficients and computed in a total score.
Multivariate analysis showed that direct blood flow to wounds (OR 9.5, 95%CI 3.6–24.8, p < 0.001), no hemodialysis (OR 5.6, 95%CI 2.2–14.2, p < 0.001), no gangrene (OR 5.2, 95%CI 1.9–14.1, p = 0.001), alb levels (≥ 3.0) (OR 2.4, 95%CI 1.1–5.5, p = 0.029) and wounds not extending to the dorsal or plantar surface of the foot (OR 8.9, 95%CI 2.9–27.0, p < 0.001) were independent predictors of wound healing. Each item's score ranged from 0 to 3 and the total score ranged from 0 to 10. The area under the receiver operating characteristic curve shows that there was 90.1% accuracy in the total scores predicting the likelihood of wound healing. The major amputation rates among low–risk (scores > 7), moderate–risk (scores 4–6), and high–risk (scores>3) groups were 3.9%, 13.8%, and 47.5%, respectively (P < 0.001).
This new scoring system (WHPS) was useful for prediction of wound healing and risk stratification for major amputation.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Vascular Medicine: Endovascular Therapy I
Abstract Category: 34. Vascular Medicine: Endovascular Therapy
Presentation Number: 1165–159
- 2013 American College of Cardiology Foundation