Blood Cell Count Biomarkers, Risk, and Outcomes of Ischemia-Related Lower Limb Amputations: A Systematic Review

Dettori, Paola; Mangoni, Arduino A.; Zinellu, Angelo; Carru, Ciriaco; Paliogiannis, Panagiotis

doi:10.1177/1534734620961785

Cited by 4 publications

(2 citation statements)

References 57 publications

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“…Hence, the importance of developing methods allows for objectifying the choice of the optimal level of amputation with the aim of maximally reducing this level without increasing the risk of early purulent-necrotic postoperative complications is understood [3,4]. These complications are the result of excessively «economical» amputation, when the line of excision of the limb falls on tissues with impaired tissue metabolism and insufficient oxygenation, therefore, it is important to develop diagnostic methods which would help determine the «ideal» level of amputation [5,6].…”

Section: Introductionmentioning

confidence: 99%

Level Selection of Non-Traumatic Lower Extremity Amputations in Patients With Critical Ischemia

Vasyliuk

Osadets

Prudnikov

et al. 2022

Modern Medical Technology

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Objective. To evaluate the informativeness of ultrasound scanning of the lower limb arteries and angiography in patients with critical ischemia for choosing the optimal level of extremity amputation. Methods. Treatment of 289 patients with obliterative diseases of the arteries of the lower extremities of various genesis with the indications for amputation of the damaged lower extremity was analyzed. Results. Ultrasound scanning of arteries could not always characterize the severity of collateral circulation, but indicated only the level of occlusion. However, the severity of chronic ischemia of the lower limb is determined not only by the level of occlusion, but also by the severity of collateral blood flow at the same level of damage. That is why, in our opinion, the results of an ultrasound examination of the lower limb arteries cannot be decisive when choosing the level of amputation. Angiography made it possible to characterize not only the level of occlusion or stenosis, but also the state of collateral circulation, which had a decisive influence on the choice of the method of limb amputation. Conclusion. Ultrasound examination of the lower extremity vessels allows to establish the level of occlusion, but is uninformative for the assessment of collateral anastomoses, which is an important factor in choosing the level of non-traumatic amputation of the lower extremity. In patients with critical ischemia, transtibial amputations should be avoided, as they show worse results. The operation of choice should be a transfemoral amputation or non-traumatic through-knee amputation.

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Section: Introductionmentioning

confidence: 99%

Level Selection of Non-Traumatic Lower Extremity Amputations in Patients With Critical Ischemia

Vasyliuk

Osadets

Prudnikov

et al. 2022

Modern Medical Technology

View full text Add to dashboard Cite

show abstract

“…

Indeed, the only area not covered is medical writing and education, a favourite subject during the last 3 years. [4][5][6] Dettori et al 7 have carried out a systematic review examining the role of blood cell count indices of systemic inflammation in the risks and outcomes of ischaemic lower limb amputations. Another systematic review and meta-analysis has been conducted by Shahrokh et al 8 to investigate bacterial isolates and resistance to antibiotics in infected diabetic foot ulcers in Iran.

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confidence: 99%

The Longest and Richest

Παπάνας

Papi²

2022

The International Journal of Lower Extremity Wounds

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Role of Neutrophil-Lymphocyte Ratio and Mean Platelet Volume in the Outcome of Atherosclerotic Peripheral Vascular Disease Interventions

Yalamuru

Balaji²,

Robinson³

et al. 2022

Indian Journal of Vascular and Endovascular Surgery

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Purpose: Classically, neutrophils have been neglected in the pathophysiology of atherosclerosis. However, recent studies have highlighted their role. Similarly, the role of platelets in peripheral artery disease (PAD) has become evident now. The significance of neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) has been independently studied and found that elevated values are associated with poor outcomes of atherosclerotic peripheral vascular disease interventions. However, the measure of association of NLR and MPV to the outcomes of intervention has not been studied. Hence, this study was undertaken to examine the measure of association of NLR and MPV to the outcomes of atherosclerotic peripheral vascular disease interventions. Methodology: This is a prospective study conducted between January 1, 2020, and September 30, 2021, with 6 months of follow-up. Patients aged 21 years or more, diagnosed to have atherosclerotic peripheral vascular disease, and undergoing interventions (endovascular and open procedure) are included in the study. Patients <21 years, not willing for any intervention, and with acute presentations were excluded. The primary endpoint assessed is graft patency at 6 months, and the secondary endpoints assessed are clinical improvement (which is a combined measure of change in ankle–brachial index, Rutherford grade, and ulcer status) at 1 and 6 months, redo procedure, and amputations within the follow-up period. Results: From January 2020 to September 2021, a total of 156 patients with atherosclerotic peripheral vascular disease fulfilled the inclusion and exclusion criteria. We observed that in 109 (69.9%) patients who had completed 6-month follow-up, 91 (83.5%) patients had graft patency and 18 (16.5%) patients had occluded graft. Independent receiver operating characteristic curve analysis of MPV and NLR showed that lower mean NLR and MPV values (cutoff taken as 10.15 for MPV) are associated with increased graft patency at 6 months than higher mean NLR and MPV values (NLR, P < 0.001; MPV, P = 0.024). Discriminant analysis model developed with MPV and NLR as the set of predictors showed that NLR and MPV together are good predictors of graft patency at 6 months (Wilk's lambda: χ2 = 45.54, P < 0.001). However, logistic regression analysis has shown that, in comparison to NLR, MPV is not a strong predictor of graft patency. Lower mean NLR value was associated with lower amputation rate (P < 0.001), lower mortality rate (P < 0.001), and higher clinical improvement rate at 1st month (P < 0.001) and at 6 months (P < 0.001) than patients with higher mean NLR. However, there was no statistically significant difference between two groups in predicting chance of redo procedure (P = 0.424). There was no statistically significant difference between the mean MPV values among patients who underwent amputation (P = 0.864), died (P = 0.640), or had redo procedure (P = 0.883), except for clinical improvement outcome where lower mean MPV value was associated with higher rate of clinical improvement at 1st month (P < 0.001) and 6 months (P < 0.001) than higher mean MPV value. Conclusion: In patients with atherosclerotic peripheral vascular disease, NLR value is a better predictor of outcomes after intervention than MPV, and lower mean NLR values are associated with increased rate of graft patency, clinical improvement, fewer amputations, and deaths.

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Blood Cell Count Biomarkers, Risk, and Outcomes of Ischemia-Related Lower Limb Amputations: A Systematic Review

Cited by 4 publications

References 57 publications

Level Selection of Non-Traumatic Lower Extremity Amputations in Patients With Critical Ischemia

Level Selection of Non-Traumatic Lower Extremity Amputations in Patients With Critical Ischemia

The Longest and Richest

Role of Neutrophil-Lymphocyte Ratio and Mean Platelet Volume in the Outcome of Atherosclerotic Peripheral Vascular Disease Interventions

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