TY - JOUR
T1 - Prediction Models for Two Year Overall Survival and Amputation Free Survival After Revascularisation for Chronic Limb Threatening Ischaemia
AU - Miyata, Tetsuro
AU - Kumamaru, Hiraku
AU - Mii, Shinsuke
AU - Kinukawa, Naoko
AU - Miyata, Hiroaki
AU - Shigematsu, Kunihiro
AU - Azuma, Nobuyoshi
AU - Ishida, Atsuhisa
AU - Izumi, Yuichi
AU - Inoue, Yoshinori
AU - Uchida, Hisashi
AU - Ohki, Takao
AU - Kuma, Sosei
AU - Kurosawa, Koji
AU - Kodama, Akio
AU - Komai, Hiroyoshi
AU - Komori, Kimihiro
AU - Shibuya, Takashi
AU - Shindo, Shunya
AU - Sugimoto, Ikuo
AU - Deguchi, Juno
AU - Hoshina, Katsuyuki
AU - Hideaki, Maeda
AU - Midorikawa, Hirofumi
AU - Yamaoka, Terutoshi
AU - Yamashita, Hiroya
AU - Yunoki, Yasuhiro
N1 - Funding Information:
This study was supported by The Japanese Society for Vascular Surgery.
Publisher Copyright:
© 2022 European Society for Vascular Surgery
PY - 2022/10
Y1 - 2022/10
N2 - Objective: The aim of this study was to create prediction models for two year overall survival (OS) and amputation free survival (AFS) after revascularisation in patients with chronic limb threatening ischaemia (CLTI). Methods: This was a retrospective analysis of prospectively collected multicentre registry data (JAPAN Critical Limb Ischaemia Database; JCLIMB). Data from 3 505 unique patients with CLTI who had undergone revascularisation from 2013 to 2017 were extracted from the JCLIMB for the analysis. The cohort was randomly divided into development (2 861 patients) and validation cohorts (644 patients). In the development cohort, multivariable risk models were constructed to predict two year OS and AFS using Cox proportional hazard regression analysis. These models were applied to the validation cohort and their performances were evaluated using Harrell's C index and calibration plots. Results: Kaplan–Meier estimates of two year OS and AFS post-revascularisation in the whole cohort were 69% and 62%, respectively. Strong predictors for OS consisted of age, activity, malignant neoplasm, chronic kidney disease (CKD), congestive heart failure (CHF), geriatric nutritional risk index (GNRI), and sex. Strong predictors for AFS included age, activity, malignant neoplasm, CKD, CHF, GNRI, body temperature, white blood cells, urgent revascularisation procedure, and sex. Prediction models for two year OS and AFS showed good discrimination with Harrell's C indexes of 0.73 (95% confidence interval [CI] 0.69 – 0.77) and 0.72 (95% CI 0.68 – 0.76), respectively Conclusion: Prediction models for two year OS and AFS post-revascularisation in patients with CLTI were created. They can assist in determining treatment strategies and serve as risk adjustment modalities for quality benchmarking for revascularisation in patients with CLTI at each facility.
AB - Objective: The aim of this study was to create prediction models for two year overall survival (OS) and amputation free survival (AFS) after revascularisation in patients with chronic limb threatening ischaemia (CLTI). Methods: This was a retrospective analysis of prospectively collected multicentre registry data (JAPAN Critical Limb Ischaemia Database; JCLIMB). Data from 3 505 unique patients with CLTI who had undergone revascularisation from 2013 to 2017 were extracted from the JCLIMB for the analysis. The cohort was randomly divided into development (2 861 patients) and validation cohorts (644 patients). In the development cohort, multivariable risk models were constructed to predict two year OS and AFS using Cox proportional hazard regression analysis. These models were applied to the validation cohort and their performances were evaluated using Harrell's C index and calibration plots. Results: Kaplan–Meier estimates of two year OS and AFS post-revascularisation in the whole cohort were 69% and 62%, respectively. Strong predictors for OS consisted of age, activity, malignant neoplasm, chronic kidney disease (CKD), congestive heart failure (CHF), geriatric nutritional risk index (GNRI), and sex. Strong predictors for AFS included age, activity, malignant neoplasm, CKD, CHF, GNRI, body temperature, white blood cells, urgent revascularisation procedure, and sex. Prediction models for two year OS and AFS showed good discrimination with Harrell's C indexes of 0.73 (95% confidence interval [CI] 0.69 – 0.77) and 0.72 (95% CI 0.68 – 0.76), respectively Conclusion: Prediction models for two year OS and AFS post-revascularisation in patients with CLTI were created. They can assist in determining treatment strategies and serve as risk adjustment modalities for quality benchmarking for revascularisation in patients with CLTI at each facility.
KW - Amputation free survival
KW - Chronic limb threatening ischaemia
KW - Overall survival
KW - Risk prediction model
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U2 - 10.1016/j.ejvs.2022.05.038
DO - 10.1016/j.ejvs.2022.05.038
M3 - Article
C2 - 35680042
AN - SCOPUS:85139309612
SN - 1078-5884
VL - 64
SP - 367
EP - 376
JO - European Journal of Vascular and Endovascular Surgery
JF - European Journal of Vascular and Endovascular Surgery
IS - 4
ER -