The Global Limb Anatomic Staging System Predicts Clinical Outcomes in Chronic Limb Threatening Ischemia

Abstract

INT would have a longer DI time. Smoking status and the prescription of OMT, cilostazol, and a high-dose statin were compared among the quartiles using one-way analysis of variance.Results: A total 25,737 patients at 130 centers were diagnosed with claudication. During follow-up, 9052 patients (35.2%) at 127 centers underwent intervention: 14.2% of the interventions had occurred #30 days from diagnosis, 32.9% at #90 days, and 53.1% at #180 days. The median DI time and %INT varied significantly between center quartiles (P < .001 for both). However, medical management was uniform across all quartiles, with w65% of patients prescribed OMT (P ¼ .38) and w50% active smokers at the time of intervention (P ¼ .11; Table ). As hypothesized, an inverse relationship was found between the %INT and the median DI time (Spearman coefficient, À0.47; P < .001; Fig).Conclusions: We found significant variability in the adherence to guideline recommended management of claudication within the VHA system. Opportunity for quality improvement exists to standardize medical and surgical treatment algorithms. Further research is necessary to ascertain how early intervention affects limb outcomes such as reintervention and amputation.