Can a rapid-access vascular limb salvage service improve one-year amputation outcomes for patients with chronic limb-threatening ischaemia? Article Swipe
Andrew Nickinson
,
Jivka Dimitrova
,
John S M Houghton
,
Lauren Rate
,
Svetlana Dubkova
,
H. Lines
,
Laura J. Gray
,
Sarah Nduwayo
,
Tanya Payne
,
Robert D. Sayers
,
Robert Davies
·
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.1101/19013037
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.1101/19013037
Background Vascular limb salvage services can potentially improve outcomes for patients with chronic limb-threatening ischaemia (CLTI), although their description within the literature is limited. This study aims to evaluate the 12-month outcomes for an outpatient-based vascular limb salvage (VaLS) clinic and investigate times-to-treatment. Methods An analysis of a prospectively maintained database, involving all patients diagnosed with CLTI within the VaLS clinic from February 2018-February 2019, was undertaken. Data were compared to two comparator cohorts, identified from coding data; 1) patients managed prior to the clinic, between May 2017-February 2018 (Pre-Clinic’ [PC]), and 2) patients managed outside of clinic, between February 2018-February 2019 (‘Alternative Pathways’ [AP]). Freedom from major amputation at 12 months was the primary outcome. Kaplan-Meier plots and adjusted Cox’s proportional hazard models (aHR) were utilised to compare outcomes. Results Five-hundred and sixty-six patients (VaLS=158, AP=173, PC=235) were included (median age=74 years). Patients managed within the VaLS cohort were significantly more likely to be free from major amputation (90.5%) compared to both the AP (82.1%, aHR 0.52, 95% CI 0.28-0.98, p=.041) and the PC (80.0%; aHR 0.50, 95% CI 0.28-0.91, p=.022) cohorts at 12 months, after adjustment for age, disease severity and presence of diabetes. Conclusions A limb salvage clinic may help improve the rate of major amputation and provides a reproducible model which delivers timely vascular assessment in an ambulatory setting. Further evaluation is required to assess longer-term outcomes.
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Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.1101/19013037
- https://www.medrxiv.org/content/medrxiv/early/2020/08/19/19013037.full.pdf
- OA Status
- green
- Cited By
- 1
- References
- 33
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2996725187
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W2996725187Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1101/19013037Digital Object Identifier
- Title
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Can a rapid-access vascular limb salvage service improve one-year amputation outcomes for patients with chronic limb-threatening ischaemia?Work title
- Type
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preprintOpenAlex work type
- Language
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enPrimary language
- Publication year
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2019Year of publication
- Publication date
-
2019-11-27Full publication date if available
- Authors
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Andrew Nickinson, Jivka Dimitrova, John S M Houghton, Lauren Rate, Svetlana Dubkova, H. Lines, Laura J. Gray, Sarah Nduwayo, Tanya Payne, Robert D. Sayers, Robert DaviesList of authors in order
- Landing page
-
https://doi.org/10.1101/19013037Publisher landing page
- PDF URL
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https://www.medrxiv.org/content/medrxiv/early/2020/08/19/19013037.full.pdfDirect link to full text PDF
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YesWhether a free full text is available
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greenOpen access status per OpenAlex
- OA URL
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https://www.medrxiv.org/content/medrxiv/early/2020/08/19/19013037.full.pdfDirect OA link when available
- Concepts
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Medicine, Amputation, Cohort, Ambulatory, Hazard ratio, Proportional hazards model, Internal medicine, Surgery, Confidence intervalTop concepts (fields/topics) attached by OpenAlex
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1Total citation count in OpenAlex
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2025: 1Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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