Background: The white blood cell count (WCC) is known to be predictive of cardiac and cerebral vascular events. No one has yet investigated this in critical limb ischaemia (CLI).
Methods: Baseline WCC was examined in relation to lower limb amputation 6 months after a 4 week treatment period with i.v. placebo or i.v. taprostene in 366 patients with CLI.
Results: The WCC was related to a significant increase in amputation, relative risk 1.6 (p=0.001, 95% CI: 1.2-2.0) in CLI patients with WCC > or =9x10(9)/l vs patients with WCC <9x10(9)/l. Its association with disabling amputation persisted on logistic regression analyses which included cigarette smoking as a variable and also treatment group (p<0.001). The WCC is therefore an easily measurable prognostic variable in CLI.
Conclusions: The white blood cell may promote intractable tissue ischaemia by capillary plugging and/or release of toxic chemicals and may have distinct effects on tissue viability.
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