Background: Endovascular treatment (EVT) is essential for limb salvage in patients with critical limb ischemia (CLI). On the other hands, previous research reported the presence of CLI was strongly associated with mortality. It is not acceptable to have excessive aggressive treatment for patients with worse prognosis from the point of ethics and medical economics. In this study, we sought to investigate relationship between initial activities of daily living (ADL) of CLI patients and mortality after EVT.
Methods: This study was a retrospective observational study. From January 2013 to March 2017, total of 139 patients with CLI who underwent EVT were enrolled. Patients were classified into three groups with their ADL: independent group (n=70), partially dependent group (n=57) and totally dependent group (n=12). Outcome measure was all-cause mortality with each group.
Results: Mean follow-up period was 484±427 days. Total mortality was 26.6% within follow-up period. Kaplan-Meier survival curve showed that freedom from all-cause death at one year was 82% in independent group, 68.5% in partially dependent group and 39.7% in totally dependent group(P<0.001).
Conclusion: In patients with CLI, mortality was strongly affected by their previous ADL before EVT. Mortality of patients with totally dependent ADL was significantly high, and therefore excessive aggressive treatment should be well considered.