Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Gary, T; Belaj, K; Hafner, F; Eller, P; Rief, P; Hackl, G; Brodmann, M.
Graz Critical Limb Ischemia Score: A Risk Score for Critical Limb Ischemia in Peripheral Arterial Occlusive Disease.
Medicine (Baltimore). 2015; 94(27):e1054-e1054
Doi: 10.1097/MD.0000000000001054
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- Führende Autor*innen der Med Uni Graz
- Gary Thomas
- Co-Autor*innen der Med Uni Graz
- Belaj Klara
- Brodmann Marianne
- Eller Philipp
- Hackl Gerald
- Hafner Franz
- Rief Peter
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- Abstract:
- Critical limb ischemia (CLI), a frequently encountered disorder, is associated with a high rate of limb amputation and mortality. To identify patients at high risk for CLI, we developed a simple risk score for peripheral arterial occlusive disease (PAOD).In our cross-sectional study, we first evaluated 1000 consecutive PAOD patients treated at our institution from 2005 to 2007, documenting clinical symptoms, comorbidities, and concomitant medication. We calculated odds ratios (OR) in a binary logistic regression model to find possible risk factors for CLI. We then verified the score in a second step that included the 1124 PAOD patients we treated between 2007 and 2011.In the first patient group, the greatest risk factors for CLI were age ≥75 years (OR 2.0), type 2 diabetes (OR 3.1), prior myocardial infarction (OR 2.5), and therapy with low molecular weight heparins (2.8). We scored 1 point for each of those conditions. One point was given for age between 65 and 75 years (OR 1.6) as well as for therapy with cardiac glycosides (OR 1.9) or loop diuretic therapy (OR 1.5). As statin therapy was protective for CLI with an OR of 0.5, we subtracted 1 point for those patients.In the second group, we could prove that frequency of CLI was significantly higher in patients with a high CLI score. The score correlated well with inflammatory parameters (c-reactive protein and fibrinogen). We were also able to define 3 different risk groups for low (score -1 to 1), intermediate (score 2-4), and high CLI risk (score >4).We developed a simple risk stratification scheme that is based on conditions that can be easily assessed from the medical history, without any laboratory parameters. This score should help to identify PAOD patients at high risk for CLI.
- Find related publications in this database (using NLM MeSH Indexing)
- Age Factors -
- Aged -
- Aged, 80 and over -
- Arterial Occlusive Diseases - complications
- Cardiovascular Agents - administration & dosage
- Comorbidity -
- Cross-Sectional Studies -
- Diabetes Mellitus, Type 2 - complications
- Extremities - blood supply
- Female -
- Humans -
- Hypoglycemic Agents - administration & dosage
- Ischemia - etiology
- Male -
- Microcirculation -
- Middle Aged -
- Myocardial Infarction - complications
- Odds Ratio -
- Peripheral Arterial Disease - complications
- Risk Assessment -
- Risk Factors -