Mitsuyoshi Takahara1,2, Osamu Iida3, Yoshimitsu Soga4, Akio Kodama5, Hiroto Terashi6, Kenji Suzuki7, Ikuo Sugimoto8, Nobuyoshi Azuma9. 1. Department of Metabolic Medicine, Osaka University Graduate School of Medicine. 2. Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine. 3. Cardiovascular Center, Kansai Rosai Hospital. 4. Department of Cardiology, Kokura Memorial Hospital. 5. Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine. 6. Department of Plastic Surgery, Kobe University Graduate School of Medicine. 7. Department of Cardiology, Tokyo Saiseikai Central Hospital. 8. Department of Vascular Surgery, Aichi Medical University. 9. Department of Vascular Surgery, Asahikawa Medical University.
Abstract
Aim: Critical limb ischemia (CLI) has a wide age distribution. We aimed here to reveal age-associated clinical features in CLI patients. Materials and Methods: We analyzed 531 Japanese CLI patients referred to vascular centers. The three-year mortality risk by age was compared to that for the Japanese nationals, derived from Japan's national life table data. Clinical characteristics associated with age in CLI patients were also explored. Results: Mean age was 73±10 years. Whereas 27.9% were aged ≥80 years, 19.2% were aged <65 years. Mortality risk was increased with age, but its risk ratio relative to the same-aged nationals was higher in younger patients. Incidence of major amputation was higher in a younger population. Receiving welfare, smoking, increased body mass index, diabetes with hemoglobin A1c ≥7.0%, non-high density lipoprotein cholesterol ≥190 mg/dL, renal failure, and the Wound, Ischemia, and foot Infection classification stage 4 were associated with younger age, whereas non-ambulation and institutionalization were associated with older age. Conclusion: Patients aged <65 years, belonging to the working-age population, reached almost one fifth of the CLI population. Younger patients had a lower mortality risk in the population, but had a higher risk ratio relative to the same-aged nationals. Socioeconomic disadvantage, poor cardiovascular risk control, and wound severity were associated with younger age.
Aim: Critical limb ischemia (CLI) has a wide age distribution. We aimed here to reveal age-associated clinical features in CLI patients. Materials and Methods: We analyzed 531 Japanese CLI patients referred to vascular centers. The three-year mortality risk by age was compared to that for the Japanese nationals, derived from Japan's national life table data. Clinical characteristics associated with age in CLI patients were also explored. Results: Mean age was 73±10 years. Whereas 27.9% were aged ≥80 years, 19.2% were aged <65 years. Mortality risk was increased with age, but its risk ratio relative to the same-aged nationals was higher in younger patients. Incidence of major amputation was higher in a younger population. Receiving welfare, smoking, increased body mass index, diabetes with hemoglobin A1c ≥7.0%, non-high density lipoprotein cholesterol ≥190 mg/dL, renal failure, and the Wound, Ischemia, and foot Infection classification stage 4 were associated with younger age, whereas non-ambulation and institutionalization were associated with older age. Conclusion:Patients aged <65 years, belonging to the working-age population, reached almost one fifth of the CLI population. Younger patients had a lower mortality risk in the population, but had a higher risk ratio relative to the same-aged nationals. Socioeconomic disadvantage, poor cardiovascular risk control, and wound severity were associated with younger age.
Authors: Michael S Conte; Andrew W Bradbury; Philippe Kolh; John V White; Florian Dick; Robert Fitridge; Joseph L Mills; Jean-Baptiste Ricco; Kalkunte R Suresh; M Hassan Murad; Victor Aboyans; Murat Aksoy; Vlad-Adrian Alexandrescu; David Armstrong; Nobuyoshi Azuma; Jill Belch; Michel Bergoeing; Martin Bjorck; Nabil Chakfé; Stephen Cheng; Joseph Dawson; Eike S Debus; Andrew Dueck; Susan Duval; Hans H Eckstein; Roberto Ferraresi; Raghvinder Gambhir; Mauro Gargiulo; Patrick Geraghty; Steve Goode; Bruce Gray; Wei Guo; Prem C Gupta; Robert Hinchliffe; Prasad Jetty; Kimihiro Komori; Lawrence Lavery; Wei Liang; Robert Lookstein; Matthew Menard; Sanjay Misra; Tetsuro Miyata; Greg Moneta; Jose A Munoa Prado; Alberto Munoz; Juan E Paolini; Manesh Patel; Frank Pomposelli; Richard Powell; Peter Robless; Lee Rogers; Andres Schanzer; Peter Schneider; Spence Taylor; Melina V De Ceniga; Martin Veller; Frank Vermassen; Jinsong Wang; Shenming Wang Journal: Eur J Vasc Endovasc Surg Date: 2019-06-08 Impact factor: 7.069
Authors: William M Schultz; Heval M Kelli; John C Lisko; Tina Varghese; Jia Shen; Pratik Sandesara; Arshed A Quyyumi; Herman A Taylor; Martha Gulati; John G Harold; Jennifer H Mieres; Keith C Ferdinand; George A Mensah; Laurence S Sperling Journal: Circulation Date: 2018-05-15 Impact factor: 29.690
Authors: Joseph L Mills; Michael S Conte; David G Armstrong; Frank B Pomposelli; Andres Schanzer; Anton N Sidawy; George Andros Journal: J Vasc Surg Date: 2013-10-12 Impact factor: 4.268