Long-term mortality and its predictors in patients with critical leg ischaemia. The I.C.A.I. Group (Gruppo di Studio dell'Ischemia Cronica Critica degli Arti Inferiori). The Study Group of Criticial Chronic Ischemia of the Lower Exremities

Abstract

Objective: To assess the predictivity of predefined variables with respect to long-term mortality in a cohort of patients with chronic critical leg ischaemia (CLI).

Design: Prospective observational study.

Methods: Census offices were asked to release information on survival or death status of 574 patients with CLI 2 years after their recruitment in the study.

Results: Of 522 patients with available information, 165 (31.6%) died within 2 years of hospital admission, mostly from vascular causes as expected. Among the variables considered, male sex, current smoking, arterial hypertension, diabetes mellitus, hypercholesterolaemia, obesity, history of myocardial infarction and low ankle systolic pressure showed no univariate association with mortality. The multivariate analysis also excluded revascularisation procedures and the Fontaine stage as prognostic factors in terms of mortality. Besides age > or = 70 years (relative risk, RR 1.94; 95% confidence interval (CI) 1.37-2.70), only a history of stroke (RR 1.82; 95% CI 1.19-2.79) and major amputation (RR 1.90; 95% CI 1.30-2.80) were significantly associated with mortality.

Conclusions: CLI is a clinical condition of such severity that most of the recognised cardiovascular risk factors cannot further influence the fate of the patients, one-third of whom die within 2 years.