首页|Inadequacies of Physical Examination in Patients with Acute Lower Limb Ischemia Are Associated with Dreadful Consequences
Inadequacies of Physical Examination in Patients with Acute Lower Limb Ischemia Are Associated with Dreadful Consequences
扫码查看
点击上方二维码区域，可以放大扫码查看
原文链接
NSTL
Elsevier
? 2021Background: Acute lower limb ischemia (ALI) is limb and life-threatening. The aim of this study was to explore the association between adherence to guidelines on clinical diagnosis of ALI and outcome at 1 year. The hypothesis was that that better examination was associated with favorable outcome in ALI patients. Methods: Retrospective cohort study between 2015 and 2018. In-hospital, operation, radiological and autopsy registries captured 161 citizens of Malm? with ALI. The initial bedside evaluation was performed by an emergency physician. Scoring was based on evaluation of the 6 “Ps” and 1 point was given for pain, pallor, pulselessness, perishing cold, paresthesia, paralysis or ankle-brachial pressure index (ABI). The performance was scored (range 0–7), and a score ≥5 was defined as a satisfactory vascular leg status. A multivariate logistic regression was performed to adjust for confounders and expressed in Odds Ratios (OR) with 95% confidence intervals (CI). Results: A satisfactory first clinical examination was performed in 55.3% of the patients. Measurement of ABI (OR 0.25, 95% CI 0.11–0.55), performing complete pulse status (OR 0.41, 95% CI 0.20–0.85), evaluating paralysis (OR 0.43, 95% CI 0.20–0.89), and a bedside score ≥5 points (OR 0.48, 95% CI 0.23–0.97) were independently associated with reduced risk of major amputation/mortality at 1-year follow up. Conclusions: Quality of initial bedside evaluation in patients with ALI was unsatisfactory to a large extent and better clinical examinations were associated with favorable outcome at 1 year. Skills in clinical diagnostics in ALI needs to be much improved.
Kulezic A.、Macek M.、Acosta S.
展开 >
Department of Clinical Sciences Malm? Lund University
NSTL
Elsevier
