Discrepancy in Outcomes after Revascularization for Chronic Limb-Threatening Ischemia Warrants Separate Reporting of Rest Pain and Tissue Loss

Abstract Introduction Chronic Limb-Threatening Ischemia (CLTI) manifests as tissue loss (TL) and rest pain (RP). Outcomes of lower extremity revascularization (LER) for CLTI have traditionally been evaluated as a single entity and compared with claudication. We hypothesize that patients presenting with TL have worse short-term outcomes after LER, compared to patients with RP. Methods The National Inpatient Sample (NIS) was reviewed between 2009-2013. All patients undergoing LER for TL and RP were identified. Patient characteristics, Charlson comorbidity index (CCI), length of stay (LOS), rates of inpatient major amputation and mortality after LER were noted. Multivariable regression analysis was performed to identify predictors of inpatient mortality and major amputation between the two groups. Results A total of 218,628 patients underwent LER (RP = 76,108, TL = 142,519). Patients with TL were more likely to undergo endovascular LER (RP = 31.3% vs TL = 48.7%; P Conclusion There is significant discrepancy in outcomes of LER for TL and RP. TL is independently associated with major amputation and inpatient mortality. Outcomes of LER for TL and RP should be reported separately for benchmarking.