Teams formally defined as specializing in chronic limb-threatening ischemia (CLTI) were associated with a decreased risk of major amputation among a subset of BEST-CLI trial sites, a paper recently published online ahead of print in the Journal of Vascular Surgery (JVS) showed.
Responses from a post-trial electronic survey were used to describe CLTI care providers and characterize centers based on the presence of a “formally defined team dedicated to the care of CLTI patients.”
The research was led by first author Douglas W. Jones, MD, an associate professor of surgery in the Division of Vascular Surgery at UMass Memorial Medical Center in Worcester, Massachusetts.
With an overall response rate of 20.2% and at least one response from 75% of enrolling sites, respondents identified that the specialties most frequently among those primarily responsible for CLTI care at centers with CLTI teams were revascularization specialists—namely, vascular surgery, interventional cardiology or interventional radiology (92%), as well as podiatry (32%) and wound care (22%).
Compared to centers without CLTI teams, podiatrists at CLTI team centers were more likely to have a primary role (32% vs. 11%) and less likely to be unavailable (4% vs. 22%), the authors reported. Similarly, at centers with CLTI teams, wound care specialists were more likely to have a primary role (22% vs. 8%) and less likely to be unavailable (4% vs. 11%). Effectiveness of teamwork among CLTI providers was described as “highly effective” in 71% of respondents with a CLTI team vs. 29% without a team.
On multivariable analysis, presence of a CLTI team was independently associated with decreased major amputation, the researchers found.
