PMID- 35650020
OWN - NLM
STAT- MEDLINE
DCOM- 20230303
LR  - 20230305
IS  - 1880-3873 (Electronic)
IS  - 1340-3478 (Print)
IS  - 1340-3478 (Linking)
VI  - 30
IP  - 3
DP  - 2023 Mar 1
TI  - Injury Precipitating Tissue Loss and Time to Referral to a Vascular Center in 
      Patients with Chronic Limb-Threatening Ischemia.
PG  - 287-298
LID - 10.5551/jat.63593 [doi]
AB  - AIM: This study aimed to report injury precipitating tissue loss and to provide 
      updated information on the time from tissue loss occurrence to referral to a 
      vascular center for patients who developed chronic limb-threatening ischemia 
      (CLTI) in Japan. METHODS: We examined 450 patients who developed CLTI with tissue 
      loss and were registered in a multicenter prospective study between October 2017 
      and June 2020. They were referred to the participating vascular centers for 
      revascularization. Information on the injury precipitating tissue loss and time 
      to referral was collected at registration. The severity of tissue loss was 
      evaluated using the Wound, Ischemia, and foot Infection classification. RESULTS: 
      Injury precipitating tissue loss was absent in 52.0% (95% confidence interval, 
      47.3%-56.6%) of the patients. The absence was associated with lower albumin 
      levels and preserved pressure sensation. Although the time to referral was 
      significantly shorter in cases without a history of prereferral 
      revascularization, 16.8% (12.8%-20.7%) of the patients were referred to the 
      vascular centers more than 3 months after tissue loss occurrence. Time to 
      referral, but not the lack of a clear precipitant for tissue loss, was 
      significantly associated with the severity of tissue loss. CONCLUSION: A clear 
      precipitant for tissue loss was often lacking, particularly in patients with low 
      albumin levels and preserved pressure sensation. Delayed referral to a vascular 
      center is still common.
FAU - Takahara, Mitsuyoshi
AU  - Takahara M
AD  - Department of Diabetes Care Medicine, Osaka University Graduate School of 
      Medicine.
FAU - Iida, Osamu
AU  - Iida O
AD  - Cardiovascular Center, Kansai Rosai Hospital.
FAU - Ohura, Norihiko
AU  - Ohura N
AD  - Department of Plastic, Reconstructive Surgery, Kyorin University School of 
      Medicine.
FAU - Soga, Yoshimitsu
AU  - Soga Y
AD  - Department of Cardiology, Kokura Memorial Hospital.
FAU - Yamaoka, Terutoshi
AU  - Yamaoka T
AD  - Department of Vascular Surgery, Matsuyama Red Cross Hospital.
FAU - Azuma, Nobuyoshi
AU  - Azuma N
AD  - Department of Vascular Surgery, Asahikawa Medical University.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20220602
PL  - Japan
TA  - J Atheroscler Thromb
JT  - Journal of atherosclerosis and thrombosis
JID - 9506298
RN  - 0 (Albumins)
SB  - IM
MH  - Humans
MH  - *Chronic Limb-Threatening Ischemia
MH  - *Peripheral Arterial Disease/complications
MH  - Chronic Disease
MH  - Prospective Studies
MH  - Risk Factors
MH  - Albumins
PMC - PMC9981346
OTO - NOTNLM
OT  - Chronic limb-threatening ischemia
OT  - Precipitating injury
OT  - Severity of tissue loss
OT  - Time to referral
EDAT- 2022/06/02 06:00
MHDA- 2023/03/04 06:00
PMCR- 2023/03/01
CRDT- 2022/06/01 22:32
PHST- 2022/06/02 06:00 [pubmed]
PHST- 2023/03/04 06:00 [medline]
PHST- 2022/06/01 22:32 [entrez]
PHST- 2023/03/01 00:00 [pmc-release]
AID - DN/JST.JSTAGE/jat/63593 [pii]
AID - 10.5551/jat.63593 [doi]
PST - ppublish
SO  - J Atheroscler Thromb. 2023 Mar 1;30(3):287-298. doi: 10.5551/jat.63593. Epub 2022 
      Jun 2.