PMID- 38345882
OWN - NLM
STAT- MEDLINE
DCOM- 20240214
LR  - 20240214
IS  - 2184-9927 (Print)
IS  - 2184-9927 (Linking)
VI  - 30
IP  - 4
DP  - 2024 Feb 9
TI  - Wound, Ischemia, Foot Infection (Wifi) Classification System And Its Predictive 
      Ability Concerning Amputation-Free Survival, Mortality And Major Limb Amputation 
      In A Portuguese Population: A Single Center Experience.
PG  - 51-58
LID - 10.48729/pjctvs.364 [doi]
AB  - INTRODUCTION: Commonly used chronic limb-threatening ischemia (CLTI) 
      classifications lack granularity and detail to precisely stratify patients 
      according to risk of limb loss, expected revascularization benefit and mortality. 
      The aim of this study is to evaluate in a Portuguese population the prognostic 
      value of an updated CLTI classification based on Wound, Ischemia, and foot 
      Infection (WIfI) proposed by the Society for Vascular Surgery. MATERIALS AND 
      METHODS: Single-center retrospective evaluation of prospectively collected data 
      of consecutive patients with CLTI submitted to lower limb revascularization from 
      January to December of 2017. All consecutive patients with chronic peripheral 
      artery disease with ischemic rest pain or tissue loss were included. The 
      exclusion criteria were patients with intermittent claudication, vascular trauma, 
      acute ischemia, non-atherosclerotic arterial disease and isolated iliac 
      intervention. The primary end-point was major limb amputation, mortality and 
      amputation-free survival (AFS) at 30 days, 1 year and 2 year follow-up. Secondary 
      end-points were minor amputation, wound healing time (WHT) and rate (WHR). 
      RESULTS: A total of 111 patients with CLTI were submitted to infra-inguinal 
      revascularization: 91 endovascular and 20 open surgery. After categorizing them 
      according to the WIfI: 20 had stage 1 (18.52%), 29 stage 2 (26.85%), 38 stage 3 
      (35.19%) and 21 stage 4 (19.44%). Overall mortality rate was 1.8%, 17% and 22.3% 
      at 30 days, 1 year and 2 years follow-up. Major amputation rate was 0.9%, 2.7% 
      and 2.7% at 30 days, 1 year and 2 years follow-up. AFS rate was 97.3%, 82.1%, and 
      76.8% at 30 days, 1 year, 2 years follow-up. In multi-variable analysis, higher 
      WIfI score was the only predictive factor for mortality and AFS. WIfI 3 and 4 
      were also associated with increased risk of non-healing ulcer. CONCLUSION: This 
      study proved the prognostic value of the WIfI classification in a Portuguese 
      population by showing an association between higher scores and increased 
      mortality, lower AFS and non-healing ulcer.
FAU - Alves, Duarte Gil
AU  - Alves DG
AD  - General Surgery Department, Hospital Dr. Nelio Mendonca. Portugal.
FAU - Ferreira, Vitor
AU  - Ferreira V
AD  - Angiology and Vascular Surgery Department, Centro Hospitalar do Tamega e Sousa. 
      Portugal.
FAU - Teixeira, Gabriela
AU  - Teixeira G
AD  - Angiology and Vascular Surgery Department, Centro Hospitalar do Tamega e Sousa. 
      Portugal.
FAU - Vasconcelos, Joao
AU  - Vasconcelos J
AD  - Angiology and Vascular Surgery Department, Centro Hospitalar do Tamega e Sousa. 
      Portugal.
FAU - Maia, Miguel
AU  - Maia M
AD  - Angiology and Vascular Surgery Department, Centro Hospitalar do Tamega e Sousa. 
      Portugal.
FAU - Vidoedo, Jose
AU  - Vidoedo J
AD  - Angiology and Vascular Surgery Department, Centro Hospitalar do Tamega e Sousa. 
      Portugal.
FAU - Almeida Pinto, Joao
AU  - Almeida Pinto J
AD  - Angiology and Vascular Surgery Department, Centro Hospitalar do Tamega e Sousa. 
      Portugal.
LA  - eng
PT  - Journal Article
DEP - 20240209
PL  - Portugal
TA  - Port J Card Thorac Vasc Surg
JT  - Portuguese journal of cardiac thoracic and vascular surgery
JID - 9918249514506676
SB  - IM
MH  - Humans
MH  - Treatment Outcome
MH  - Risk Factors
MH  - Limb Salvage/adverse effects
MH  - Retrospective Studies
MH  - Portugal/epidemiology
MH  - Ulcer/etiology
MH  - *Wound Infection/diagnosis
MH  - Amputation, Surgical
MH  - *Peripheral Arterial Disease/diagnosis
MH  - *Focal Infection/etiology
MH  - Ischemia/diagnosis
MH  - Chronic Limb-Threatening Ischemia
OTO - NOTNLM
OT  - Amputation
OT  - Diabetic foot
OT  - Foot Ulcer
OT  - Infection
OT  - Ischemia
OT  - Peripheral Arterial Disease
EDAT- 2024/02/12 18:43
MHDA- 2024/02/12 18:44
CRDT- 2024/02/12 12:13
PHST- 2023/03/31 00:00 [received]
PHST- 2023/10/22 00:00 [accepted]
PHST- 2024/02/12 18:44 [medline]
PHST- 2024/02/12 18:43 [pubmed]
PHST- 2024/02/12 12:13 [entrez]
AID - 10.48729/pjctvs.364 [doi]
PST - epublish
SO  - Port J Card Thorac Vasc Surg. 2024 Feb 9;30(4):51-58. doi: 10.48729/pjctvs.364.