Shiraki et al identified risk factors for mortality following revascularization for critical limb ischemia. These can help to identify a patient who may benefit from more aggressive management. The authors are from Osaka University and Kobe University in Japan.
Patient selection: revascularization for critical limb ischemia
Outcome: mortality within 2 years
BEACH (Bypass and Endovascular therapy against Critical limb ischemia from Hyogo) score:
(1) age > 75 years
(2) non-ambulatory status (wheelchair use or bedridden)
(3) regular dialysis
(4) left ventricular ejection fraction less than 50%
Number of Risk Factors
Risk Group
2-Year Mortality
0
low
2%
1 or 2
moderate
22%
3 or 4
high
71%
The area under the ROC curve is 0.81.
For patients on hemodialysis (one of the risk factors for the BEACH score) risk factors for 2-year mortality were:
(1) age > 75 years
(2) serum albumin < 3.0 g/dL
(3) left ventricular ejection fraction less than 50%
Number of Risk Factors
2-Year Mortality
0
20%
1
35%
2
54%
3
71%
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