Age does not predict need for reintervention in patients with critical limb ischemia

Objective Conventional wisdom holds that patients with a need for intervention for femoropopliteal occlusive disease at a younger age have more aggressive disease, although there is a paucity of support in the literature. The purpose of this study was to evaluate this assumption. Methods A retrospec...

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Bibliographic Details
Published in:Journal of vascular surgery 2015-02, Vol.61 (2), p.413-418
Main Authors: Torrent, Daniel J., MD, MPH, Zink, Jill N., MD, Bogey, William M., MD, Powell, C. Steven, MD, Parker, Frank M., MD, Yamaguchi, Dean J., MD, Stoner, Michael Clinton, MD, RVT
Format: Article
Language:English
Subjects:
Age Factors
Aged
Amputation
Constriction, Pathologic
Critical Illness
Endovascular Procedures - adverse effects
Endovascular Procedures - mortality
Femoral Artery
Humans
Ischemia - diagnosis
Ischemia - mortality
Ischemia - surgery
Ischemia - therapy
Kaplan-Meier Estimate
Limb Salvage
Lower Extremity - blood supply
Male
Middle Aged
Multivariate Analysis
Peripheral Arterial Disease - diagnosis
Peripheral Arterial Disease - mortality
Peripheral Arterial Disease - surgery
Peripheral Arterial Disease - therapy
Popliteal Artery
Proportional Hazards Models
Reoperation
Retrospective Studies
Risk Factors
Surgery
Time Factors
Treatment Outcome
Vascular Surgical Procedures - adverse effects
Vascular Surgical Procedures - mortality
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Summary:Objective Conventional wisdom holds that patients with a need for intervention for femoropopliteal occlusive disease at a younger age have more aggressive disease, although there is a paucity of support in the literature. The purpose of this study was to evaluate this assumption. Methods A retrospective cohort of patients undergoing endovascular or open revascularization for femoropopliteal occlusive disease for critical limb ischemia during a 4-year period was assembled. Demographic information, comorbidities, disease characteristics, and time to last follow-up, repeat intervention, amputation, or death was recorded. The patients were stratified by age into a young (≤55 years) group, middle (56-77 years) group, and elderly (≥78 years) group. Univariate and multivariate statistical methods were used to evaluate the primary outcome. Results The study included 124 patients with a mean age of 64.4 ± 0.8 years. Progression to reintervention or amputation occurred in 50% of the patients during the follow-up period, with 18% dying before having an outcome. Kaplan-Meier analysis showed a trend toward significance ( P  = .06) in time to reintervention, amputation, or death among the three groups, with time to event of 253, 1083, and 504 days for the young, middle, and elderly groups, respectively. However, differences based on age were not significant ( P  = .57) in Cox regression analysis. Conclusions There does not appear to be an association between time to reintervention and patient age.
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2014.08.006