High risk and low prevalence diseases: Acute limb ischemia

Arnold, Jacob; Koyfman, Alex; Long, Brit

doi:10.1016/j.ajem.2023.09.052

Cited by 4 publications

(1 citation statement)

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“…Its incidence has been estimated to be around 10-15 cases per 100,000 individuals per year in the general population [16], this figure includes non-traumatic forms, both of thrombotic or embolic origin. ALI can occur in both the upper and lower limbs, the latter being by far the more prevalent accounting for more than 80% of total cases of limb ischemia [17,18] and clinically relevant form [19]. The prognosis of this condition is poor both for the affected limb and for the patient, with an estimated one-year rate of unfavorable outcomes (death/major amputation) as high as 46.6% for lower ALI [20].…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19 on Amputation and Mortality Rates in Patients with Acute Limb Ischemia: A Systematic Review and Meta-Analysis

Crupi,

Ardizzone,

Calapai

et al. 2024

Diseases

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Since the inception of the SARS-CoV-2 pandemic, healthcare systems around the world observed an increased rate of Acute Limb Ischemia (ALI) in patients with a COVID-19 infection. Despite several pieces of evidence suggesting that COVID-19 infection may also worsen the prognosis associated with ALI, only a small number of published studies include a direct comparison regarding the outcomes of both COVID-19 and non-COVID-19 ALI patients. Based on the above, a systematic review and a meta-analysis of the literature were conducted, evaluating differences in the incidence of two major outcomes (amputation and mortality rate) between patients concurrently affected by COVID-19 and negative ALI subjects. PubMed (MEDLINE), Web of Science, and Embase (OVID) databases were scrutinized from January 2020 up to 31 December 2023, and 7906 total articles were recovered. In total, 11 studies (n: 15,803 subjects) were included in the systematic review, and 10 of them (15,305 patients) were also included in the meta-analysis. Across all the studies, COVID-19-positive ALI patients experienced worse outcomes (mortality rates ranging from 6.7% to 47.2%; amputation rates ranging from 7.0% to 39.1%) compared to non-infected ALI patients (mortality rates ranging from 3.1% to 16.7%; amputation rates ranging from 2.7% to 18%). Similarly, our meta-analysis shows that both the amputation rate (OR: 2.31; 95% CI: 1.68–3.17; p < 0.00001) and mortality (OR: 3.64; 95% CI: 3.02–4.39; p < 0.00001) is significantly higher in COVID-19 ALI patients compared to ALI patients.

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