Investigation of the effect of acute to chronic glycemic ratio on major amputation development after surgical thromboembolectomy in patients with acute lower extremity ischemia

Abstract

Background Acute limb ischemia (ALI) is an emergency vascular pathology in which perfusion is disrupted in the lower extremity and threatens extremity viability. The admission blood glucose (ABG)/estimated average glucose (eAG) value has recently been shown as a prognostic marker in acute cardiovascular events. In this study, we aimed to investigate the predictive role of an ABG/eAG value in predicting development of early postoperative major amputation after emergency thromboembolectomy operations in patients presenting with ALI. Method Patients who admitted to our hospital with ALI between November 01, 2016 and September 01, 2021 and underwent surgical thromboembolectomy were retrospectively included in the study. Patients who did not undergo postoperative limb amputation were recorded as Group 1, and patients who underwent major amputation in the early postoperative period (in-hospital), were recorded as Group 2. Results The median age of the 226 patients included in Group 1 and 72 patients in Group 2 were 58 (34–86) years and 69 (33–91) years, respectively ( p<0.001). In univariate analysis, in-hospital amputation was found to significantly correlate with age>70 years (odds ratio [OR]: 1.914, 95% confidence interval [CI]: 1.351–2.319, p<0.001), PAD (OR: 1.698, 95% CI: 1.270–1.992, p = 0.002 re-embolectomy (OR: 2.184, 95% CI: 1.663–3.085, p < 0.001), admission Rutherford class (OR: 0.762, 95% CI: 0.591–0.859, p = 0.032), admission time>6 h (OR: 1.770, 95% CI: 1.480–1.152, p = 0.009), ABG (OR: 1.275, 95% CI: 1.050–1.790, p < 0.001), and ABG/eAG (OR: 1.669, 95% CI: 1.315–2.239, p < 0.001). Conclusion According to our study, we can predict patient groups with a high risk of major amputation with the ABG/eAG value calculated from the blood values of the patients at the time of admission.