الفهرس | Only 14 pages are availabe for public view |
Abstract This study comprehensively evaluated patients with critical limb ischemia (CLI) undergoing revascularization interventions, focusing on demographics, comorbidities, laboratory findings, wound characteristics, clinical outcomes, survival analysis, and predictors of wound healing. Demographics and Comorbidities: The study included 114 patients with CLI, with a median age of 60 years, a majority being male (64.9%), and a notable percentage being smokers (45.6%). Common comorbidities included diabetes (77.2%), hypertension (45.6%), and chronic kidney disease (42.1%). Ambulatory status varied, with 78.1% being ambulant and 21.9% bedridden. Laboratory Investigations: Patients exhibited elevated total leucocytic count (TLC) and positive C-reactive protein (CRP) levels, indicative of an inflammatory response. Median hemoglobin level was 11.5 g/dL, and median serum albumin level was 2.9 g/dL. Tissue Loss and Wound characteristics: Tissue loss primarily presented as gangrene (51.8%) and ulcers (42.1%), with a smaller percentage experiencing minor amputations (6.1%). Most patients had single wounds (89.5%), mainly located in the toes (58.8%) and heels (29.8%). Wound infections were prevalent in 50.9% of patients. Clinical Outcomes: Endovascular intervention was more common (85.96%) than open surgery (14.04%). Successful wound healing occurred in 43% of patients, with a median healing duration of 112 days. Major amputation and death rates were 5.2% and 8.8%, respectively. Survival Analysis: Kaplan-Meier analysis showed gradual wound healing over 180 days, with complete healing observed in 43% of patients. Ambulant patients had higher healing rates compared to bedridden patients, and heel site wounds exhibited slower healing rates. Predictors of Wound Healing: Multivariate logistic regression identified age < 60 years and endovascular intervention as predictors of higher odds of wound healing. Conversely, being bedridden and having wound infection were associated with lower odds of healing. The study highlights the multifaceted nature of CLI and emphasizes the importance of tailored interventions and infection control in optimizing clinical outcomes. These findings contribute to the understanding of factors influencing wound healing and inform clinical decision-making in the management of CLI. |