Surgical management and outcomes of late-presenting acute limb ischaemia at 2 referral hospitals in Addis Ababa, Ethiopia: A 1-year prospective study
Journal – East and Central African Journal of Surgery
Article type – Journal research article – Clinical research
Publication date – May – 2021
Authors – Nebyou Seyoum, Berhanu D. Mekonnen, Berhanu N. Alemu
Keywords – Acute Limb Ischemia, Embolism, Re-vascularization, Thrombosis
Open access – Yes
Speciality – Emergency surgery, Vascular surgery
World region Eastern Africa
Language – English
Submitted to the One Surgery Index on May 27, 2021 at 2:45 am
Objective: The study was performed to show the overall perspective of surgical management for acute limb ischemia specific to Ethiopian population.
Methods: A prospective planned cohort study was conducted to analyze the socio-demography, clinical presentation, causes of limb ischemia, and outcomes of surgical intervention, and variables associated with complications of acute limb ischemia.
Results:A total of 102 patients were operated upon. The male to female ratio was 2:1; the mean age of presentation was 54±17 years. Patients presented after an average of 9±4.8 days of symptom onset. The type of procedures performed were, thrombectomy 51(47.2%), primary amputation 24(22.2%), bypass or interposition vascular grafts 10(9.2%), embolectomy 10(9.2%), primary vascular repair 7(6.4%), and femoro-femoral graft 6(5.5%). Local and systemic complications occurred in 35.3% and 17.6% respectively. Amputation after re-vascularization surgery was seen in 32.4%. A 30-day total amputation & mortality rate was 52.9% and 9.8% respectively. Clinical variables found to have a statistical significant association (P<0.05) with complications were age ≥ 60 years, late presentation (≥ 9days), patients with hypertensive disease and previous myocardial infarction.
Conclusions: Optimizing co-morbidities, timely detection and treating immediately on arrival could potentially play a key role in improving surgical outcomes of acute limb ischemia.
OSI Number – 21104