Risk factors associated with amputation-free survival for patients with peripheral arterial disease: a systematic review

被引:15
作者
Kim, Changhwan [1 ]
Yang, Yong Sook [2 ]
Ryu, Gi Wook [2 ]
Choi, Mona [2 ,3 ]
机构
[1] Samsung Med Ctr, Dept Crit Care Nursing, 81 Irwon Ro, Seoul 06351, South Korea
[2] Yonsei Univ, Coll Nursing, Mo Im Kim Nursing Res Inst, 50-1 Yonsei Ro, Seoul 03722, South Korea
[3] JESI Ctr Excellence, Yonsei Evidence Based Nursing Ctr Korea, 50-1 Yonsei Ro, Seoul 03722, South Korea
基金
新加坡国家研究基金会;
关键词
Peripheral arterial disease; Intermittent claudication; Amputation-free survival; Risk factors; Aftercare; Systematic review; CRITICAL LIMB ISCHEMIA; LONG-TERM OUTCOMES; ENDOVASCULAR PROCEDURES; OPEN BYPASS; THERAPY; INDEX; REVASCULARIZATION; DETERMINANTS; MULTICENTER; INTERVENTION;
D O I
10.1093/eurjcn/zvaa022
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims Peripheral arterial disease (PAD) is associated with morbidity and mortality, comprising a significant percentage of amputations. As it affects the quaky of life of patients with PAD, it is an important health issue. Therefore, the risk factors affecting the outcomes of limb salvage after revascularization should be well investigated. The aim of this review is to summarize risk factors of amputation-free survival (AFS) after interventions targeting patients with PAD to develop evidence-based intervention for improving patient outcomes. Methods and results A systematic review following PRISMA guidelines was conducted, and the protocol was registered on PROSPERO (CRD42020183076). PubMed, CINAHL, EMBASE, Cochrane Library, and Web of Science were searched for observational studies published between 2008 and 2019. Search terms included 'peripheral arterial disease', 'risk factors', and 'amputation-free survival'. The quality of the studies was evaluated using the Joanna Briggs Institute's Critical Appraisal Tools. Seventeen cohort studies were included in our study, and 16 risk factors were identified. Risk factors exemplifying a significant influence on decreased AFS were divided into three categories: sociodemographic (e.g. older age, male gender, African-American race, low body mass index, high nutritional risk, frailty), disease-related characteristics (e.g. severity of the disease, intervention site), and comorbidities (e.g. cardiovascular disease, kidney disease, diabetes mellitus, chronic obstructive pulmonary disease, dementia, wide pulse pressure). Conclusion We found that managing modifiable risk factors, as well as addressing high-risk populations, has the potential to improve outcomes of PAD interventions. More high-quality cohort studies are needed to confirm these findings.
引用
收藏
页码:295 / 304
页数:10
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