Survival benefits of revascularization in patients with critical limb ischemia and renal insufficiency Jana Ortmann, MD, Brigitta Gahl, MD, Nicolas Diehm,

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Presentation transcript:

Survival benefits of revascularization in patients with critical limb ischemia and renal insufficiency Jana Ortmann, MD, Brigitta Gahl, MD, Nicolas Diehm, MD, Florian Dick, MD, Tobias Traupe, MD, Iris Baumgartner, MD Journal of Vascular Surgery Volume 56, Issue 3, Pages 737-745.e1 (September 2012) DOI: 10.1016/j.jvs.2012.02.049 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Hazard ratios from univariable (left) and hazard ratios and forest plots from multivariable analysis (right). Cox proportional hazard models compare the effects of revascularization vs medical therapy on (A) amputation-free survival and (B) overall survival separately for all critical limb ischemia (CLI) patients, and for CLI patients with absent/mild renal insufficiency (RI), moderate RI, and severe RI, respectively. Multivariable Cox models were adjusted for age, sex, diabetes, hypertension, and smoking. P values were calculated using the two-sided Wald test derived from Cox-proportional hazard models. GFR, Glomerular filtration rate. Journal of Vascular Surgery 2012 56, 737-745.e1DOI: (10.1016/j.jvs.2012.02.049) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 Kaplan-Meier survival curves for cumulative outcome estimates of primary efficacy study end points for (A, C, and E) amputation-free survival and (B, D, and F) overall survival calculated separately for revascularization and medical therapy (MT) for critical limb ischemia (CLI) patients with (A and B) absent/mild renal insufficiency (RI), (C and D) moderate RI, and (E and F) severe renal insufficiency, respectively. P values were calculated using χ2 test derived from Cox proportional hazard models. Numbers at risk are given for patients. GFR, Glomerular filtration rate. Journal of Vascular Surgery 2012 56, 737-745.e1DOI: (10.1016/j.jvs.2012.02.049) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig. 3 Hazard ratios from univariable (left) and hazard ratios and forest plots from multivariable analysis (right). Cox proportional hazard models to compare the effects of revascularization vs medical therapy (MT) on (A) clinical success and (B) limb salvage separately for all critical limb ischemia (CLI) patients, and for CLI patients with absent/mild renal insufficiency (RI), moderate RI, and severe RI, respectively. Multivariable Cox models were adjusted for age, sex, diabetes, hypertension, and smoking. P values were calculated using two-sided Wald test derived from Cox-proportional hazard models. *In the severe RI group, coefficients did not converge because of complete separation and low patient numbers. The bivariable analysis yielded P = .309 (Fisher exact test) with six amputations, all in the immediate revascularization group. GFR, Glomerular filtration rate. Journal of Vascular Surgery 2012 56, 737-745.e1DOI: (10.1016/j.jvs.2012.02.049) Copyright © 2012 Society for Vascular Surgery Terms and Conditions