الفهرس | Only 14 pages are availabe for public view |
Abstract Objective: To provide a mathematical equation conclude a scoring system for predication of limb salvage (or major amputation) in critical limb ischemia (CLI) Design: Pilot study, observational analytical study. Methods: This study was conducted on 226 cases in the Department of Vascular Surgery in Kasr Al-Ainy Hospital {u2013} Cairo University between March 2018 to October 2019. This study was conducted in two phases:The first phase: the generation group consists of 112 cases (half of them fate major amputation) in which the clinical, radiological and operative variables were collected and detect patients who need major amputation in 30 days and verify predictors of limb salvage, which was subjected to statistical tests in order to determine the most important factors that were translated into a mathematical equation to determine the probability failure of limb salvage of major amputation.The second phase: the validation group includedtesting validity of the equation on 114 individuals and comparing the results of its forecasts of the probability of amputation (expected results) by what has happened with these cases according to the current vascular guidelines (observed results). Results: The TLC, total CK, serum urea level and incomplete foot arch are independent factors directly proportional to the possibility of major amputation. Open interventions and presence of inline distal runoff enter the foot are independent factors inversely proportional to the possibility of major amputation. Anemia and active cardiac condition are risk factors for major amputation. The proposed equation is: Y = -4.084 + (0.218 X TLC) + (0.007 X CK-total) + (0.015 X Urea) + (-2.954 X Open intervention [1]) + -2.694 X Inline distal runoff [1]) + (3.767 X Incomplete foot arch [1])The value resulting from the equation (Y value) is calculated by its natural exponential function 2EXP(Y)3 and then the probability value of amputation is calculated. Probability = (EXP(Y))/((1+EXP(Y))) |