Association Between Preoperative Frailty and Mortality in Patients With Critical Limb Ischemia Following Infrainguinal Bypass Surgery　― Usefulness of the Barthel Index ―

DOI Web Site Web Site PubMed 13 Citations 29 References
  • Kodama Akio
    Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine
  • Koyama Akio
    Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine
  • Sugimoto Masayuki
    Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine
  • Niimi Kiyoaki
    Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine
  • Banno Hiroshi
    Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine
  • Komori Kimihiro
    Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine

Bibliographic Information

Other Title
  • Association between preoperative frailty and mortality in patients with critical limb ischemia following infrainguinal bypass surgery—usefulness of the Barthel index

Search this article

Abstract

<p>Background:Most patients with critical limb ischemia (CLI) exhibit severe comorbidities accompanied by frailty. This study assessed and risk-stratified mortality after infrainguinal bypass (IB) in CLI and investigated the effects of frailty.</p><p>Methods and Results:The study retrospectively reviewed 107 consecutive CLI patients who had undergone de novo IB due to atherosclerotic disease. Data regarding patient age, comorbidities, laboratory data, and functional status were collected; functional status was evaluated using the Barthel index (BI) and nutritional status was evaluated using albumin concentrations and body mass index (BMI). Mean (±SD) BI and BMI were 75±16 and 22±4 kg/m2, respectively. BI (hazard ratio [HR] 0.96; 95% confidence interval [CI] 0.94–0.99, P=0.004), BMI (HR 0.85; 95% CI 0.75–0.95, P=0.003), atrial fibrillation (AF; HR 5.31; 95% CI 2.12–13.30, P<0.001), and ejection fraction (EF; HR 0.94; 95% CI 0.91–0.98, P=0.003) were independent predictors of mortality. Patients were divided into 2 groups based on BI (BI >75, n=71; and BI <70, n=36). Survival after IB was significantly lower for the lower BI group (P<0.001, log-rank test). After propensity score matching, post-IB survival remained significantly lower in the lower BI group (P=0.02).</p><p>Conclusions:BI, BMI, AF, and EF were independently associated with all-cause mortality after IB for CLI. BI and BMI may be useful in identifying and optimizing treatment for high-risk frail patients.</p>

Journal

  • Circulation Journal

    Circulation Journal 82 (1), 267-274, 2018

    The Japanese Circulation Society

Citations (13)*help

See more

References(29)*help

See more

Related Projects

See more

Keywords

Details 詳細情報について

Report a problem

Back to top