Prevent III score as a predictor of limb salvage and mortality after aortoiliac revascularization

Autores da FMUP

• João Manuel Palmeira Rocha Neves

  Autor

• José Paulo Alves Vieira De Andrade

  Autor

• António Henrique Pereira Neves

  Autor

Participantes de fora da FMUP

• Romana-Dias, Lara
• Alves, Diogo
• Vidoedo, Jose

Unidades de investigação

• Biomedicina

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Background: This prospective study aimed to validate the prognostic value of Prevent III (PIII) risk score in patients undergoing aortoiliac revascularization, both in limb-related outcomes and cardiovascular risk. Methods: The prospective cohort study included 130 consecutive patients (122 males, 8 females; mean age: 62.1 +/- 9.2 years; range, 53 to 71 years) undergoing elective aortoiliac revascularization between January 2013 and September 2022. Patients' demographic and clinical characteristics were retrieved and PIII scores were calculated. A risk category was assigned according to the total points: low-risk (score <= 3), medium-risk (score 4-7), or high-risk (score >= 8). Results: The median follow-up period was 55 months (interquartile range, 39 to 70 months). Twenty-four (18.5%) patients had a PIII score >= 4. Regarding short-term outcomes, patients with PIII scores >= 4 exhibited lower ankle-brachial index changes at 30 days and more extended hospital stays. There were no significant associations between PIII scores and major adverse events at 30 days. However, during follow-up, a PIII score >= 4 was associated with increased major adverse limb events (p=0.036) and all-cause mortality (p=0.007). Conclusion: The PIII score is a reliable predictor of long-term limb and mortality risk in patients undergoing aortoiliac revascularization procedures, leveraging five user-friendly clinical parameters. More research with larger cohorts and studies comparing PIII with other validated scores should be performed in the future.

Keywords

• Major adverse cardiac events; peripheral arterial disease; prospective studies; risk assessment; survival analysis