{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:30:09Z","timestamp":1772991009228,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"1-2","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute limb ischaemia (ALI) is a vascular emergency that often involves life\u2010or\u2010limb\u2010threatening consequences. For patients with irreversible limb ischaemia or those who are high\u2010risk surgical candidates, palliative care may be underutilised. This study examined the role and use of palliative care for ALI patients at our institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational study was conducted for ALI patients referred to the vascular service from January 2019 to December 2023. Data collected included demographics, comorbidities using the Charlson comorbidity index (CCI), the primary intervention offered and their Australia\u2010modified Karnofsky Performance Status (AKPS). Outcomes included 30\u2010day mortality, major limb amputation and referral to palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 114 patients, with median age of 75, and 65 male patients were included. On presentation, 2 patients (1.8%) underwent major limb amputation and 15 patients (13.2%) received palliative care. Patients who received palliative care on presentation were, on average, older by 11.4\u2009years, had a higher CCI score by 2.7 and a lower AKPS by 19.1 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) compared to patients who did not receive palliative care. Within 30\u2009days, 12 (80%) of the primary palliation group died, compared to 8 (8.1%) in the non\u2010palliation group. None of the patients who underwent amputation received palliative care or died within 30\u2009days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ALI is associated with high mortality. In selected patients, particularly those with non\u2010viable limbs, advanced age, high comorbidity burden and low functional status, early palliative care may be more appropriate than surgery. Avoiding \u2018palliative amputation\u2019 through timely palliative care involvement offers a more holistic, patient\u2010centred approach to care at the end of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70479","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T12:47:02Z","timestamp":1768222022000},"page":"178-184","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Role of Palliative Care in the Management of Acute Lower Limb Ischaemia"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4663-1614","authenticated-orcid":false,"given":"Jun Cheul","family":"Park","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery Waikato Hospital  Hamilton New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricky","family":"Kwok","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Waikato Hospital  Hamilton New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacey","family":"Hooper","sequence":"additional","affiliation":[{"name":"Department of Palliative Care Waikato Hospital  Hamilton New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Eckoldt","sequence":"additional","affiliation":[{"name":"Department of Palliative Care Waikato Hospital  Hamilton New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Palliative Care Waikato Hospital  Hamilton New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sinead","family":"Gormley","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Waikato Hospital  Hamilton New 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