Digital ischaemia aetiologies and mid-term follow-up: A cohort study of 323 patients.
Adult
Aged
Aged, 80 and over
Amputation, Surgical
/ statistics & numerical data
Embolism
/ complications
Female
Fingers
/ blood supply
Follow-Up Studies
Humans
Iatrogenic Disease
/ epidemiology
Ischemia
/ epidemiology
Kaplan-Meier Estimate
Male
Marijuana Smoking
/ adverse effects
Middle Aged
Necrosis
/ epidemiology
Neoplasms
/ complications
Recurrence
Retrospective Studies
Risk Factors
Scleroderma, Systemic
/ complications
Survival Rate
Thromboangiitis Obliterans
/ complications
Thrombosis
/ complications
Tobacco Smoking
/ adverse effects
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
21 May 2021
21 May 2021
Historique:
received:
16
06
2020
accepted:
05
04
2021
entrez:
20
5
2021
pubmed:
21
5
2021
medline:
27
5
2021
Statut:
ppublish
Résumé
Upper extremity digital ischaemia (UEDI) is a rare heterogeneous condition whose frequency is 40 times less than that of toe ischaemia. Using a large cohort, the aim of this study was to evaluate aetiologies, prognosis and midterm clinical outcomes of UEDI.All patients with UEDI with or without cutaneous necrosis in a university hospital setting between January 2000 to December 2016 were included. Aetiologies, recurrence of UEDI, digital amputation and survival were analyzed retrospectively.Three hundred twenty three patients were included. UEDI due to cardio-embolic disease (DICE) was the highest occurring aetiology with 59 patients (18.3%), followed by DI due to Systemic Sclerosis (SSc) (16.1%), idiopathic causes (11.7%), Thromboangiitis obliterans (TAO) (9.3%), iatrogenic causes (9.3%), and cancer (6.2%). DICE patients tended to be older and featured more cases with arterial hypertension whereas TAO patients smoked more tobacco and cannabis. During follow-up, recurrences were significantly more frequent in SSc than in all other tested groups (P < .0001 vs idiopathic and DICE, P = .003 vs TAO) and among TAO patients when compared to DICE patients (P = .005). The cumulated rate of digital amputation was higher in the SSc group (n = 18) (P = .02) and the TAO group (n = 7) (P = .03) than in DICE (n = 2).This retrospective study suggests that main aetiologies of UEDI are DICE, SSc and idiopathic. This study highlights higher frequency of iatrogenic UEDI than previous studies. UEDI associated with SSc has a poor local prognosis (amputations and recurrences) and DICE a poor survival. UEDI with SSc and TAO are frequently recurrent.
Identifiants
pubmed: 34011027
doi: 10.1097/MD.0000000000025659
pii: 00005792-202105210-00008
pmc: PMC8136985
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e25659Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no funding and conflicts of interests to disclose.
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