WIfI Risk Staging and Limb Salvage Status in Patients with Chronic Limb-Threatening Ischemia: A Cross-Sectional Study
Keywords:
amputation, chronic limb-threatening ischemia, peripheral arterial disease, risk stratification, smoking, wound infectionAbstract
Background: Chronic limb-threatening ischemia is a severe manifestation of peripheral artery disease with substantial risk of limb loss. Structured threatened-limb staging may improve risk identification, yet evidence linking WIfI stage with limb salvage status in Indonesian referral settings remains limited
Aim: To examine the association between WIfI risk staging and limb salvage status in patients with chronic limb-threatening ischemia
Approach: This cross-sectional study included 127 adults with chronic limb-threatening ischemia recruited by consecutive sampling between August 14 and October 17, 2025. Eligible participants had a complete WIfI assessment and documented limb salvage status. Data were analyzed using bivariable tests and multivariable logistic regression with 2-sided testing
Results: The mean (SD) age was 62.8 (10.7) years, and 84 participants (66.1%) were men. Unfavorable limb salvage status occurred in 38 patients (29.9%). Advanced WIfI stage (3-4) was associated with unfavorable limb salvage status in the adjusted model (adjusted odds ratio [aOR], 5.78; 95% CI, 2.08-16.09; P = .001). Chronic kidney disease (aOR, 2.91; 95% CI, 1.20-7.05; P = .02) and current smoking (aOR, 2.36; 95% CI, 1.01-5.54; P = .048) were also independently associated with the outcome, whereas diabetes mellitus was not statistically significant after adjustment (aOR, 2.10; 95% CI, 0.79-5.58; P = .14).
Conclusions: Advanced WIfI stage was associated with poorer limb salvage status in patients with chronic limb-threatening ischemia. Chronic kidney disease and current smoking were additional factors associated with unfavorable limb status
Implication for Clinical Practice: Routine WIfI-based assessment may support earlier risk stratification, multidisciplinary communication, and salvage-oriented care planning for patients with advanced limb threat in referral vascular practice.
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