Accuracy of SVS-WIfI Classification in Predicting Major Amputation in Critical Limb Ischemic Patients

Abstract

In 2014, The Society for Vascular Surgery revealed a new classification system for Critical Limb Ischemia (CLI) referred as the Society for Vascular Surgery Lower Extremity Threatened Limb Classification System based on Wound, Ischemia, and foot Infection (SVS WIfI). This scoring system was created to stratify major amputations risk within 1 year and benefit of revascularization for the patient. This study aimed to assess the accuracy of SVS WIFi in predicting major amputations in patients with lower limb ischemia underwent revascularization at Department of Surgery, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin General Hospital in 2016 - 2019. This was a retrospective observational analytic study with cohort design. Patients who fulfilled the inclusion criteria were assessed with SVS WIfI and results after 1 year of revascularization were identified. Data were analyzed statistically using the Chi-square test. 0f 56 subjects, 39 had limb salvage and 17 underwent major amputations within 1 year. In high revascularization benefit group, 31 had limb salvage and 7 underwent amputation. Meanwhile, in moderate-low revascularization benefits group, 8 had limb salvage and 10 underwent amputation. The accuracy of the SVS WIfI recommendation was 73.2%. Therefore, WIfI SVS classification accurately predicts the incidence of major amputations in patients with lower limb ischemia who underwent revascularization.