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Angiology
Article . 2021
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Evolution of Major Amputation Risk in Patients Hospitalized in France for Critical Limb Ischemia: The COPART Registry

Authors: Alice Coudene; Francois-Xavier Lapébie; Ileana Desormais; P. Lacroix; Valerie Aurillac; Marion Mangin; V. Aboyans; +4 Authors

Evolution of Major Amputation Risk in Patients Hospitalized in France for Critical Limb Ischemia: The COPART Registry

Abstract

Over the past decade, improvements in medical treatment and revascularization techniques have been beneficial for patients with peripheral artery disease in the late stage of critical limb ischemia (CLI). We evaluated the putative reduction in the number of major amputees in the Cohorte des Patients ARTeriopathes (COPART) cohort over time. Patients were selected from this multicenter cohort, from 2006 to 2016, for CLI according to Trans-Atlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease II criteria. Patients included before and after 2011 were compared. Patients were followed for 1 year. Primary outcome was the rate of major amputations. Secondary outcomes were minor amputations, deaths from all causes, cardiovascular deaths; 989 patients were included, 489 before 2011 and 450 after 2011. There was a significant decrease in rates of major amputation after 2011 (17% vs 25%), confirmed in multivariate analysis (odds ratio [OR]: 1.5 [1.1-2.2]), an increase in revascularization, particularly distal angioplasty (OR: 2.7 [1.7-4.4]) and increased statin intake (OR: 1.6 [1.1-2.1]). For secondary outcomes, there was no significant difference. Limb prognosis of CLI patients has improved over the past decade, possibly due to more revascularizations, particularly distal ones, and increased statin use.

Keywords

Male, MESH: Peripheral Arterial Disease / diagnosis, Time Factors, Surgical / trends, MESH: Hospitalization, MESH: Ischemia / therapy, MESH: Endovascular Procedures / trends, Cohorte des Patients ARTeriopathes, MESH: Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use, Surgical / mortality, Ischemia, Risk Factors, 80 and over, MESH: Endovascular Procedures / mortality, Registries, MESH: Ischemia / diagnosis, MESH: Aged, Aged, 80 and over, MESH: France / epidemiology, MESH: Middle Aged, MESH: Ischemia / mortality, Endovascular Procedures, Middle Aged, Limb Salvage, MESH: Peripheral Arterial Disease / mortality, Hospitalization, Surgical / adverse effects, Treatment Outcome, MESH: Peripheral Arterial Disease / therapy, MESH: Critical Illness, Female, France, critical limb ischemia, MESH: Limb Salvage / trends, Critical Illness, 610, peripheral artery disease, Risk Assessment, Amputation, Surgical, Peripheral Arterial Disease, MESH: Amputation, Humans, major amputation, Aged, MESH: Humans, MESH: Endovascular Procedures / adverse effects, MESH: Male, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, prognosis, Hydroxymethylglutaryl-CoA Reductase Inhibitors, MESH: Female

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
6
Top 10%
Average
Top 10%
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