Relación entre la hipoalbuminemia y la supervivencia libre de amputación mayor en pacientes revascularizados por isquemia crítica de la extremidad inferior

Abstract

Introduction. Hypoalbuminemia is a marker of poor prognosis in multiple clinical settings; however, has not yet been convincingly established its involvement in the results after arterial surgery of the lower limb. This paper evaluates the impact of hypoalbuminemia in patients undergoing revascularization for critical ischemia of the lower limb. Material and Methods. A retrospective observational study of patients who underwent revascularization for critical limb ischemia in the University Hospital of Valladolid was designed. We classified the patients into two groups according to the presence of calcinosis or not when assessing the ankle-brachial index. Both groups were compared to estimate differences in major amputation, exitus, major amputation free survival, hospital stay and complications. Results. Of the 529 patients included in the study, 61 (11,5%) had arterial hypoalbuminemia; these group had a 30 days higher major amputation rate (33,3% versus 19,5%), and a year higher mortality (34% versus 13,8%) and major amputation rate (28,6% versus 17,3%). One year amputation free survival was worse in patients with hypoalbuminemia(45%, 37%, 33%, 33% y 22% versus 70%, 64%, 58%, 51% y 48% at 1, 2, 3, 4 y 5 years), as well as the rate of respiratory postoperative complications (23% versus 6.4%). Conclusion. Preoperative hypoalbuminemia in patients revascularized by critical lower limb ischemia is associated with worse short and medium term clinical outcomes in terms of exitus and major amputation, as well as a higher rate of post operatory respiratory complications