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Correlation of cerebral small vessel disease burden with outcome after lower extremity amputation. | LitMetric

Correlation of cerebral small vessel disease burden with outcome after lower extremity amputation.

J Diabetes Complications

Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland; Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland. Electronic address:

Published: September 2024

AI Article Synopsis

  • This study examined how changes in the brain linked to cerebral small vessel disease (CSVD), seen in head CT scans, affect survival rates and outcomes after lower limb amputations.* -
  • Researchers analyzed data from 240 patients who had undergone lower extremity amputation, finding that a significant portion had white matter lesions (WMLs) and infarcts, which are indicators of CSVD.* -
  • Results indicated that both mild to severe WMLs and infarcts were linked to lower overall survival and amputation-free survival rates, suggesting that head CT evaluations could help predict patient outcomes after amputation.*

Article Abstract

Aims: This study assessed whether changes associated with cerebral small vessel disease (CSVD) evaluated from head computed tomography (CT) images captured for non-related clinical purposes predict overall survival (OS), leg salvage (LS), and amputation-free survival (AFS) after lower extremity amputation (LEA).

Methods: We retrospectively included a cohort of 240 patients who had undergone a lower extremity amputation in Tampere University Hospital between the years 2007 and 2020 and had a head CT scan (within one year before amputation). A neuroradiologist graded the white matter lesions (WMLs) and reported infarcts, and the latter's effects on OS, LS, and AFS were evaluated.

Results: Altogether, 162 (67.5 %) and 91 (38.1 %) patients had WMLs and infarcts, respectively. Mild/moderate (HR 1.985, CI 95 % 1.317-2.992) and severe (HR 2.259, CI 95 % 1.501-3.399) WMLs and infarcts (HR 1.413, CI 95 % 1.029-1.940) were associated with inferior OS. After a minor amputation, mild/moderate (HR 2.012, CI 95 % 1.054-3.843) and severe (HR 3.879, CI 95 % 2.096-7.180) WMLs were similarly associated with inferior AFS.

Conclusions: Overall, WML and infarcts detected on head CT scans were associated with impaired OS after LEA and AFS after minor LEA. Evaluation of CSVD could provide useful prognostic information for clinicians.

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Source
http://dx.doi.org/10.1016/j.jdiacomp.2024.108829DOI Listing

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