Sage Journals: Discover world-class research

Abstract

Following an earlier study, the investigators sought to identify and define objective prog nostic criteria of viability at 1 year of a limb with severe chronic ischemia. A study was undertaken in 116 patients (118 limbs) (74 men and 42 women), with a mean age of 71.9 years for men and 81.6 years for women. Static transcutaneous oxygen pressure (TcPO₂) was measured with a verticalization sensitization test and inhalation of oxygen on JO and viability of the limb noted 1 year later. Logistic analysis was made of 13 oximetry parameters and two demographic parameters (age and gender). Results were analyzed in absolute terms and by tissue oxygenation ratio (TOR) (ratio between absolute TcPO₂ at the foot and at a chest reference electrode). Six factors appeared to be prog nostic factors of limb viability at 1 year, statistically significant at 6% according to threshold values: age, verticalization TcPO₂, TcPO₂ after 1 minute's inhalation of oxygen, TcPO₂ after 4 minutes' inhalation of oxygen, and slope of TcPO₂ and slope of TOR between 1 and 4 minutes' inhalation. A 1 year viability index integrating these criteria is suggested.

Get full access to this article

View all access options for this article.

References

Chomard D. , Habault P. , Ledemeney M. , et al: Prognostic aspects of TcPO2 in Iloprost treatment as an alternative to amputation. Angiology 50:283-288, 1999.

Hosmer DW , Lemershow S. : Goodness-of-fit tests for the multiple logistic regression model. Commun Statist. Part A Theor Meth A9(10):1043-1069, 1980 .

Scheffler A. , Rieger H. : A comparative analysis of transcutaneous oximetry (TcPO2) during oxygen inhalation and leg dependency in severe peripheral arterial occlusive disease. J Vasc Surg 16:128-124, 1992.

Hauser CJ , William C. , Shoemaker MD : Use of a transcutaneous PO2 regional perfusion index to quantify tissue perfusion in peripheral vascular disease. Ann Surg 197:337-343, 1983.

Chomard D. , Grard C. , Desmyttère J. : Bases Méthodologiques de l'Oxymétrie transcutanée Dynamique chez l'artériopathe au stade d'ischémie d'effort." Ann Réadaptation Méd Phys 37:305-312, 1994.

Prentice RL : A generalization of the probit and logit methods for dose response curves . Biometrics 32: 761-768, 1976.

Breslow NE , Day NE : Statistical Methods in Cancer Research. Vol 1, The Analysis of Case-Control Studies. WHO International Agency for Research in Cancer . Scientific Publication No. 32 Lyon, France.

Efron B. : The efficiency of logistic regression compared to normal discriminant analysis . J Am Statistic Assoc 70:892-898, 1975.

Hosmer DW , Lemershow S. : Applied Logistic Regression. New York: John Wiley and Sons, 1989.

10.

Jeffrey L. , Clifford C. , Eke T. : A prospective evaluation of transcutaneous oxygen measurements in the management of diabetic foot problems. J Vasc Surg 22:485-492, 1995.

11.

Padberg FT , Back TL , Thompson PN : Transcutaneous oxygen (TcPO2) estimates probability of healing in the ischemic extremity. J Surg Res 60:365-369, 1996.

12.

Wutschert R. , Bounameaux H. : Determination of amputation level in ischemic limbs. Reappraisal of the measurement of TcPO2. Diabetes Care 20:1315-1318, 1997 .

13.

Stricker H. , Kaiser U. , Frei J. , et al: Acute and long-term effects of prostaglandin E1 assessed by clinical and microcirculatory parameters in critical limb ischemia: A pilot study. Int J Microcirc: Clin Exper 16:57-63, 1996.

14.

Scheffler A. , Rieger H. : Clinical information content of transcutaneous oximetry (TcPO2) in peripheral arterial occlusive disease (a review of the methodological and clinical literature with a special reference to critical limb ischemia). Vasa 21:111-126, 1992.

15.

Transcutaneous oxygen tension measurements in the assessment of limb ischemia. Clin Physiol 11:315-320, 1991.

Criteria Predictive of Limb Viability at 1 Year in Patients with Chronic Severe Ischemia-TcPO 2 and Demographic Parameters

Abstract

Get full access to this article

References