Efficacy of VBHOM to predict outcome following major lower limb amputation

Vasc Endovascular Surg. 2012 Jul;46(5):369-73. doi: 10.1177/1538574412445600. Epub 2012 May 15.

Abstract

Purpose: This study tests an existing Vascular Biochemistry and Haematology Outcome Model (VBHOM) on independent data and presents further refinements to the model.

Methods: Data from 306 patients who underwent lower limb amputation over a 4-year period were collated. Urea, creatinine, sodium, potassium, hemoglobin, white cell count, albumin, age, gender, mode-of-admission, and short-term mortality events were extracted from the database. This study tests an existing model and trains a new model for predicting mortality using forward stepwise logistic regression.

Results: The existing model suggests a significant lack of fit (c-index = 0.665, P = .04). For the exception of gender and mode-of-admission, all predictor variables had significant univariate associations with short-term mortality (P < .05). The refined model included age, sodium, potassium, creatinine, and albumin and had good discriminatory power (c-index = 0.8, no evidence of lack of fit, P = .616).

Conclusions: Our simplified model had good predictive ability and suggests redundancy in input variables used by the existing models.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical / adverse effects
  • Amputation, Surgical / mortality*
  • Biomarkers / blood
  • Creatinine / blood
  • Discriminant Analysis
  • England
  • Female
  • Humans
  • Logistic Models
  • Lower Extremity / blood supply*
  • Male
  • Multivariate Analysis
  • Patient Selection
  • Peripheral Vascular Diseases / blood
  • Peripheral Vascular Diseases / mortality
  • Peripheral Vascular Diseases / surgery*
  • Potassium / blood
  • Risk Assessment
  • Risk Factors
  • Serum Albumin / analysis
  • Sodium / blood
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Serum Albumin
  • Sodium
  • Creatinine
  • Potassium