{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T23:28:22Z","timestamp":1772666902912,"version":"3.50.1"},"reference-count":35,"publisher":"Hogrefe Publishing Group","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vasa"],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:p> Summary. Background: With growing prevalence, end-stage renal disease (ESRD) as well as critical limb ischemia (CLI) are both conditions associated with high morbidity and mortality rates. Patients and methods: A retrospective single-centre study provided data of a German interdisciplinary vascular centre. Seventy-seven consecutive haemodialysis (HD) inpatients (median age, 73.6 years) with 91 threatened limbs with Wound, Ischemia, and foot Infection (WIfI) clinical stage 3 or 4 were evaluated for in-hospital treatment of peripheral arterial disease, limb salvage rates, major amputation (MA)-free and overall survival. Results: The 1-year MA-free limb salvage rate was 82\u00a0%. On multivariate analysis, a higher WIfI clinical stage (hazard ratio [HR], 7.54; p = 0.008) indicated a higher risk of MA, while at least one-vessel run-off to the foot after revascularization of any kind was associated with a lower risk of MA (HR, 0.17; p = 0.001). In the composite endpoint analysis, the 1-year MA-free overall survival rate was 65\u00a0%. Patients with limbs in WIfI clinical stage 4 versus stage 3 carried a more than two-fold increased hazard of death or MA (HR, 2.63; p = 0.028), while revascularization was associated with reduced risk (HR, 0.40; p = 0.021). One-year overall survival (78\u00a0%) was not associated with WIfI stage or revascularization but was worse in patients with previous symptomatic coronary artery disease (HR, 3.25; p = 0.039). During long-term follow-up over 12 years, MA-free survival probability was significantly lower in the WIfI stage 4 versus WIfI stage 3 group (HR, 1.58; p = 0.048) without significant differences in overall survival (HR, 1.10; p = 0.696). Conclusions: Lower-extremity CLI with tissue loss in HD patients is associated with high morbidity and mortality rates. WIfI clinical stage was predictive of 1-year MA-free survival, while revascularization significantly reduced MA risk but did not influence overall survival. <\/jats:p>","DOI":"10.1024\/0301-1526\/a000819","type":"journal-article","created":{"date-parts":[[2019,9,4]],"date-time":"2019-09-04T16:05:05Z","timestamp":1567613105000},"page":"63-71","source":"Crossref","is-referenced-by-count":6,"title":["Outcomes of severe limb ischemia with tissue loss and impact of \t\t\t\t\trevascularization in haemodialysis patients with wound, ischemia, and foot \t\t\t\t\tinfection (WIfI) stage 3 or 4"],"prefix":"10.1024","volume":"49","author":[{"given":"Martin","family":"Sigl","sequence":"first","affiliation":[{"name":"First Department of Medicine, University Medical \t\t\t\t\tCentre Mannheim (UMM), Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanja","family":"Noe","sequence":"additional","affiliation":[{"name":"ze:ro Praxen, Speyer, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerhard","family":"Ruemenapf","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, \t\t\t\t\tDiakonissen-Stiftungs-Krankenhaus Speyer, Gef\u00e4\u00dfzentrum Oberrhein, \t\t\t\t\t\tSpeyer, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard K.","family":"Kraemer","sequence":"additional","affiliation":[{"name":"Vth. Department of Medicine, Faculty of Medicine, \t\t\t\t\tUniversity Medical Centre Mannheim (UMM), University of Heidelberg, \t\t\t\t\t\tGermany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Morbach","sequence":"additional","affiliation":[{"name":"Department of Diabetology and Angiology, \t\t\t\t\tMarienkrankenhaus Soest and Institute for Health Services Research and Health \t\t\t\t\tEconomics, Research Centre for Health and Society, Heinrich Heine University \t\t\t\t\tD\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Borggrefe","sequence":"additional","affiliation":[{"name":"Vth. Department of Medicine, Faculty of Medicine, \t\t\t\t\tUniversity Medical Centre Mannheim (UMM), University of Heidelberg, \t\t\t\t\t\tGermany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"Amendt","sequence":"additional","affiliation":[{"name":"Department of Angiology, Cardiology and Diabetes \t\t\t\t\tassociated diseases, Diakonissenkrankenhaus Mannheim, Gef\u00e4\u00dfzentrum \t\t\t\t\tOberrhein, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"101","reference":[{"key":"c1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.05.030"},{"key":"c2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.04.071"},{"key":"c3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.08.003"},{"key":"c4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.11.045"},{"key":"c5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.03.417"},{"key":"c6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.09.055"},{"key":"c7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.09.037"},{"key":"c8","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-16-0591"},{"key":"c9","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/4870749"},{"key":"c10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.12.048"},{"key":"c11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.09.039"},{"key":"c12","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx095"},{"key":"c13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2010.08.026"},{"key":"c14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.07.057"},{"key":"c15","doi-asserted-by":"publisher","DOI":"10.1177\/1526602815592206"},{"key":"c16","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/4870749"},{"key":"c17","doi-asserted-by":"publisher","DOI":"10.1024\/0301-1526\/a000603"},{"key":"c18","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv006"},{"key":"c19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.01.029"},{"key":"c20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.09.008"},{"key":"c21","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.08.001"},{"key":"c22","doi-asserted-by":"publisher","DOI":"10.1583\/14-4692R.1"},{"key":"c23","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(98)70023-0"},{"key":"c24","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2001.115607"},{"key":"c25","doi-asserted-by":"publisher","DOI":"10.1007\/s10016-001-0161-1"},{"key":"c26","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht288"},{"key":"c27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.01.060"},{"key":"c28","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2015.07.020"},{"key":"c29","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.962233"},{"key":"c30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.02.051"},{"key":"c31","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2015-000158"},{"key":"c32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.11.036"},{"key":"c33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.06.203"},{"key":"c34","doi-asserted-by":"publisher","DOI":"10.1111\/joic.12393"},{"key":"c35","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2002.34885"}],"container-title":["Vasa"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/econtent.hogrefe.com\/doi\/pdf\/10.1024\/0301-1526\/a000819","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T03:39:21Z","timestamp":1615952361000},"score":1,"resource":{"primary":{"URL":"https:\/\/econtent.hogrefe.com\/doi\/10.1024\/0301-1526\/a000819"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,1]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1,1]]}},"alternative-id":["10.1024\/0301-1526\/a000819"],"URL":"https:\/\/doi.org\/10.1024\/0301-1526\/a000819","relation":{},"ISSN":["0301-1526","1664-2872"],"issn-type":[{"value":"0301-1526","type":"print"},{"value":"1664-2872","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,1]]}}}