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Elizabeth Horn
Dr. Margaret E. Smith presented data from BMC2 during the Southern Association for Vascular Surgery (SAVS) 47th Annual Meeting on Saturday, January 21.
“Real World Application of WIfI Scores in Chronic Limb Threatening Ischemia Patients” outlined the results of a study in which the authors worked to determine the adoption of the wound, ischemia, and foot infection (WIfi) classification system and the impact of patient factors, procedural approach, and WIfI risk assessment on short- and long-term outcomes.
Michigan patients with Chronic Limb Threatening Ischemia (CLTI) undergoing open surgical revascularization (OSR) or peripheral vascular intervention (PVI) between 2018 – 2021 were identified and categorized into risk groups by their cumulative WIfI score.
Moderate and high-risk patients had higher rates of diabetes, congestive heart failure, and renal failure, and were less likely to be current or former smokers.
The study determined that in our large statewide collaborative, increasing WIfI scores correlate with worse short- and long-term outcomes. While high-risk patients are most likely to undergo OSR, the risk of amputation increases significantly more in the PVI group as the WIfI score increases. This suggests that high-risk patients may be better served with OSR.
Given the difference in outcomes among patients screened with the WIfI classification, compared to those without, application of the WIfI system may not only risk stratify patients but may also lead to improved procedural selection.