Analysis Of Risk Factors Of Postoperative Death For The Patients With Lower Limb Ischemia During The Perioperative Period

Objective Through the analysis of the clinical data of patients,including operative typ,concomitant disease,medical history,clinical examination and laboratory tests.we try to find the factors that independently affect postoperative death for the patients with acute or chronic Lower limb ischemia during the perioperative period.Methods We first collected the clinical data of 249 postoperative patients who with lower limb ischemic in the First Affiliated Hospital of Medical University Of Anhui from January 2011 to September 2016,then11 postoperative death were collected.we collected the data including gender,age,medical record number,Time of onset to treatment,complications,hematology indexes,ankle brachial index,Rutherford grade and surgical treatment.we compared the above data of death case with those of the patients who underwent surgical treatment in the same period.The univariate analysis and unconditional logistic regression were used to analyze the related factors of perioperative death.Results11 cases of death from 249 patients were followed up,thereamong 5 ASO cases of endovascular treatment,including 1 case of stent catheter thrombolysis lasted 6 hours;the rest of 6 cases were embolectomy,which underwent bilateral femoral embolectomy in 2 cases,unilateral femoral embolectomy in 4 cases.Cause of death: 4 cases of heart failure,3 cases of multiple organ failure,2 cases of acute myocardial infarction,1 case of cerebral infarction,renal failure in 1 case.The main causes of death were heart failure and multiple organ failure,up to 63.6%(7/11).The operative mortality was 4.4%(11/249),including the mortality of acute limb ischemia arterial thrombectomy was 8.9%(6/67),and the mortality of chronic ischemia,endovascular treatment was 2.8%(5/180).The single factor of death analysis showed that CLI,heart diseases,chronic renal insufficiency,hypertension,anemia and hypoproteinemia,the mortality rates were higher than those without these complications,and the difference was statistically significant(P<0.05).The ischemia reperfusion injury in patients with lower limb ischemia and reperfusion surgery has a certain impact on perioperative mortality.Conclusions1.CLI,Anemia,COPD,hypertension,hypoalbuminemia,CK,LDH,heart disease and Renal insufficiency were independent risk factors of postoperative death for the Patients with Lower limb ischemia.The cause of death in perioperative period of lower limb ischemia is closely related to the influencing factors and the function of important organs.2.The ischemia reperfusion injury has certain effects on perioperative death in patients with lower limb ischemia.