Validation of the Risk Score of the Mortality and Lower Limb Loss Considering Ambulatory Status after Surgical Revascularization in Maintaining Patients with Dialysis

• Yamazaki Haruto

  Department of Rehabilitation, Kohno Clinical Medicine Research Institute, Shinagawa Rehabilitation Hospital

• Hayashi Hisae

  The Faculty of Rehabilitation and Care, Seijoh University

• Kawamura Morio

  Department of Physical, College of Life and Health Sciences, Chubu University

• Sasaki Ayana

  Department of Rehabilitation, Municipal Kisogawa Hospital

• Kondo Eriko

  Department of Rehabilitation, Nagoya Kyoritsu Hospital

• Ito Shinya

  Department of Rehabilitation, Karatsu Red Cross Hospital

• Wakai Kenji

  Department of Preventive Medicine, Nagoya University Graduate School of Medicine

抄録

Surgical revascularization is performed to preserve limb and to maintain functional status of patients with critical limb ischemia (CLI). The PREVENT III risk score helps to predict the postoperative course of CLI. However, this score is not available to estimate the risk of amputation or death properly in patients with hemodialysis (HD) and tissue loss (HD: 4 points, Tissue loss: 3 points), because they are classified as a high-risk group. Therefore, we investigated 213 patients with revascularized HD for CLI and proposed prognosis amputation or death for patients with HD risk score (PAD for HD risk score). PAD for HD risk score (non-ambulation: 3 points, ulcer/gangrene: 2 points, GNRI<92: 2 points, CRP>0.3 mg/dl: 1 point, Age≥75: 1 point) is more accurate for the prediction of amputation or death than the PREVENT III risk score (area under the curve [AUC]: 0.79 [95% confidence interval: CI: 0.71–0.87], p<0.01 vs. AUC: 0.63 [95%CI: 0.56–0.71]). The patients were stratified into three groups by total score in ascending order. The rate of 1-year amputation-free survival and independent ambulatory status were significantly different among three groups. PAD for HD risk score is useful for rehabilitation planning in patients with HD and CLI. (This is a translation of J Jpn Coll Angiol 2016; 56: 85–91.)

収録刊行物

• Annals of Vascular Diseases

  Annals of Vascular Diseases 10 (3), 192-196, 2017

  Annals of Vascular Diseases 編集委員会

キーワード

• dialysis
• critical limb ischemia
• surgical revascularization
• risk score
• multivariate analysis

詳細情報

• CRID: 1390282680252212736
• NII論文ID: 130006099981
• DOI: 10.3400/avd.oa.17-00063
• ISSN: 18816428
• ISSN: 1881641X
• Web Site: https://www.jstage.jst.go.jp/article/avd/10/3/10_oa.17-00063/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2018195203
• 本文言語コード: en
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