PMID- 34644651
OWN - NLM
STAT- MEDLINE
DCOM- 20220228
LR  - 20221207
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Linking)
VI  - 79
DP  - 2022 Feb
TI  - The Impact of Anemia on One-Year Amputation-Free Survival in Patients Undergoing 
      Revascularization for Chronic Limb-Threatening Ischemia: A Retrospective Cohort 
      Study.
PG  - 201-207
LID - S0890-5096(21)00666-X [pii]
LID - 10.1016/j.avsg.2021.07.020 [doi]
AB  - BACKGROUND: Anemia is potentially associated with increased morbidity and 
      mortality following vascular surgery procedures. This study investigated whether 
      peri-procedural anemia is associated with reduced 1-year amputation-free survival 
      (AFS) in patients undergoing revascularization for chronic limb-threatening 
      ischemia (CLTI). METHODOLOGY: A retrospective analysis of patients diagnosed with 
      CLTI between February 2018-February 2019, who subsequently underwent 
      revascularization, was conducted. Hemoglobin concentration measured at index 
      assessment was recorded and stratified by WHO criteria. Subsequent 
      peri-procedural red blood cell transfusions (RBC) were also recorded. The primary 
      outcome was 1-year AFS. Kaplan Meier survival analysis and Cox's proportional 
      hazard modelling were conducted to assess the effect of anemia and peri-procedure 
      transfusion on outcomes. RESULTS: 283 patients were analyzed, of which 148 
      (52.3%) were anemic. 53 patients (18.7%) underwent RBC transfusion. Patients with 
      anemia had a significantly lower 1-year AFS (64.2% vs. 78.5%, P = 0.009). A 
      significant difference in 1-year AFS was also observed based upon anemia severity 
      (P = 0.008) and for patients who received RBC transfusion (45.3% vs 77.0%, P < 
      0.001). On multivariable analysis, moderately severe anemia was independently 
      associated with increased risk of major amputation/death (aHR 1.90, 95% CI 
      1.06-3.38, P = 0.030). After adjusting for severity of baseline anemia, 
      peri-procedural RBC transfusion was associated with a significant increase in the 
      combined risk of major amputation/death (aHR 3.15, 95% CI 1.91-5.20, P < 0.001). 
      CONCLUSION: Moderately severe peri-procedural anemia and subsequent RBC 
      transfusion are independently associated with reduced 1-year AFS in patients 
      undergoing revascularization for CLTI. Future work should focus on investigating 
      alternative measures to managing anemia in this cohort.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Theuma, Francesca
AU  - Theuma F
AD  - Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, 
      Leicester, UK.. Electronic address: francesca.theuma@gmail.com.
FAU - Nickinson, Andrew T O
AU  - Nickinson ATO
AD  - Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
FAU - Cullen, Sarah
AU  - Cullen S
AD  - Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, 
      Leicester, UK.
FAU - Patel, Bhavisha
AU  - Patel B
AD  - Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, 
      Leicester, UK.
FAU - Dubkova, Svetlana
AU  - Dubkova S
AD  - Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, 
      Leicester, UK.
FAU - Davies, Robert S M
AU  - Davies RSM
AD  - Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, 
      Leicester, UK.; Department of Cardiovascular Sciences, University of Leicester, 
      Leicester, UK.
FAU - Sayers, Rob D
AU  - Sayers RD
AD  - Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, 
      Leicester, UK.; Department of Cardiovascular Sciences, University of Leicester, 
      Leicester, UK.
LA  - eng
PT  - Journal Article
DEP - 20211010
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
RN  - 0 (Biomarkers)
RN  - 0 (Hemoglobins)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Amputation, Surgical/adverse effects/mortality
MH  - Anemia/blood/*complications/diagnosis/mortality
MH  - Biomarkers/blood
MH  - Chronic Disease
MH  - Databases, Factual
MH  - Female
MH  - Hemoglobins/metabolism
MH  - Humans
MH  - Ischemia/complications/diagnosis/mortality/*surgery
MH  - Limb Salvage
MH  - Male
MH  - Middle Aged
MH  - Peripheral Arterial Disease/complications/diagnosis/mortality/*surgery
MH  - Progression-Free Survival
MH  - Registries
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - *Vascular Surgical Procedures/adverse effects/mortality
EDAT- 2021/10/14 06:00
MHDA- 2022/03/01 06:00
CRDT- 2021/10/13 20:08
PHST- 2021/03/31 00:00 [received]
PHST- 2021/06/30 00:00 [revised]
PHST- 2021/07/10 00:00 [accepted]
PHST- 2021/10/14 06:00 [pubmed]
PHST- 2022/03/01 06:00 [medline]
PHST- 2021/10/13 20:08 [entrez]
AID - S0890-5096(21)00666-X [pii]
AID - 10.1016/j.avsg.2021.07.020 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2022 Feb;79:201-207. doi: 10.1016/j.avsg.2021.07.020. Epub 2021 
      Oct 10.