ArticleMedical sciences (Basel, Switzerland)2025
Misdiagnosis of Acute Limb Ischemia from Non-Vascular Specialists Results in a Delayed Presentation and Negatively Affects Patients' Outcomes.
Article in Medical sciences (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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7 authors.
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Abstract
BACKGROUND/
objectivesAcute Limb Ischemia (ALI) is a vascular emergency which is accompanied by a significant risk of limb loss or even death. Rapid restoration of arterial perfusion using surgical and/or endovascular techniques is crucial for limb salvage. Undeniably, an accurate and prompt diagnosis is the first step to improve patient prognosis. The typical clinical presentation is not always present and the variety of symptoms may result in non-vascular specialists missing the diagnosis.
methodsIn this single-center retrospective descriptive study, we reviewed all patients hospitalized between January 2018 and January 2024 for ALI. Patients who were initially misdiagnosed, causing a delayed diagnosis > 24 h, and who therefore did not receive timely treatment, were identified. Moreover, patients with a timely diagnosis of ALI who were treated in our institution during the same time period were collected.
resultsAmong 280 ALI patients, 14 were initially misdiagnosed. The median time from initial symptoms to definite diagnosis was 38.8 days (range 1.5-365). Several specialties such as orthopedic surgeons, neurologists, and general practitioners were involved in patients' initial assessment. Three patients underwent primary amputation due to irreversible ALI, while nine underwent revascularization and one conservative treatment. Thirty-day limb salvage rate was 9/14 and thirty-day mortality was observed in one patient. Secondary interventions were needed in 65% of these cases. Patients with a delayed ALI diagnosis, when compared to those with a timely diagnosis, presented a significantly lower limb salvage rate (65% vs. 89%,
conclusionsMany patients with ALI are primarily referred to non-vascular specialties. Misdiagnosed and mistreated ALI negatively affects outcomes.
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