Lim et al reported a score for predicting clinical failure following isolated femoropopliteal peripheral vascular surgery. The authors are from Yale University and the University of California San Francisco.
Patient selection: isolated femoropopliteal peripheral vascular surgery
Outcome: clinical failure at 1-year (> 50% restenosis, patency loss, major amputation)
Parameters:
(1) age in years
(2) sex
(3) insulin-dependent diabetes
(4) serum creatinine in mg/dL
(5) prior ipsilateral minor amputation
(6) prior lower extremity revascularization (open or endovascular)
(7) antiplatelet medication
(8) leg pain
(9) ankle-brachial index (ABI)
(10) surgical acuity
(11) TASC grade
(12) number of run-off vessels
(13) calcifications
(14) occlusion length in cm
|
Parameter |
Finding |
Points |
|
age in years |
< 50 years |
3 |
|
|
>= 50 years |
0 |
|
sex |
male |
0 |
|
|
female |
2 |
|
insulin-dependent diabetes |
no |
0 |
|
|
yes |
1 |
|
serum creatinine |
< 2.0 mg/dL |
0 |
|
|
>= 2.0 mg/dL |
2 |
|
prior ipsilateral amputation |
no |
0 |
|
|
yes |
3 |
|
prior LE revascularization |
no |
0 |
|
|
yes |
3 |
|
antiplatelet drug |
no |
1 |
|
|
yes |
0 |
|
leg pain |
none or claudication |
0 |
|
|
at rest |
3 |
|
ABI |
<= 0.6 |
1 |
|
|
0.6 to 1.10 |
0 |
|
|
1.11 to 1.4 |
2 |
|
surgical acuity |
urgent |
2 |
|
|
elective |
0 |
|
TASC Grade |
A or B |
0 |
|
|
C or D |
2 |
|
number of run-off vessels |
0 or 1 |
0 |
|
|
2 or 3 |
1 |
|
calcifications |
no |
0 |
|
|
yes |
1 |
|
occlusion length in cm |
< 20 cm |
0 |
|
|
>= 20 cm |
2 |
total score =
= SUM(points for all of the items)
Interpretation:
• minimum score: 0
• maximum score: 28
|
Total Score |
Risk |
|
0 to 5 |
standard risk (9%) |
|
6 to 10 |
high risk (16%) |
|
>= 11 |
very high risk (34%) |
Performance:
• The area under the ROC curve is 0.71.
