Cull et al.1515 Cull DL, Manos G, Hartley MC, et al. An early validation of the Society for Vascular Surgery Lower Extremity Threatened Limb Classification System. J Vasc Surg. 2014;60(6):1535-41. http://dx.doi.org/10.1016/j.jvs.2014.08.107. PMid:25282695. http://dx.doi.org/10.1016/j.jvs.2014.08....
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151 |
- The higher the WIfI clinical stage, the greater the risk of amputation at 1 year and the worse the healing of wounds. |
- Diabetes was independently associated with a higher risk of amputation at 1 year. |
Zhan et al.1212 Zhan LX, Branco BC, Armstrong DG, Mills JL Sr. The Society for Vascular Surgery lower extremity threatened limb classification system based on Wound, Ischemia, and foot Infection (WIfI) correlates with risk of major amputation and time to wound healing. J Vasc Surg. 2015;61(4):939-44. http://dx.doi.org/10.1016/j.jvs.2014.11.045. PMid:25656592. http://dx.doi.org/10.1016/j.jvs.2014.11....
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201 |
- As WIfI clinical stage increases, the risk of major amputation increases, 1-year AFS reduces, and time taken for healing is prolonged. |
- Revascularization reduced the time taken for wounds to heal in patients at stage 3. |
Darling et al.1616 Darling JD, McCallum JC, Soden PA, et al. Predictive ability of the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system following infrapopliteal endovascular interventions for critical limb ischemia. J Vasc Surg. 2016;64(3):616-22. http://dx.doi.org/10.1016/j.jvs.2016.03.417. PMid:27380993. http://dx.doi.org/10.1016/j.jvs.2016.03....
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551 |
- The WIfI classification was able to predict risk of amputation at 1 year and rate of wound healing in patients with CLI who had already undergone below-the-knee endovascular treatment. |
Causey et al.1717 Causey MW, Ahmed A, Wu B, et al. Society for Vascular Surgery limb stage and patient risk correlate with outcomes in an amputation prevention program. J Vasc Surg. 2016;63(6):1563-73.e2. http://dx.doi.org/10.1016/j.jvs.2016.01.011. PMid:27036309. http://dx.doi.org/10.1016/j.jvs.2016.01....
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160 |
- This study recommends use of the WIfI classification and the Project of Ex-Vivo vein graft Engineering via Transfection III (PIII) as supplementary tools for management of CLTI. |
- The WIfI classification had a good correlation with length of hospital stay and with severe adverse limb events, such as amputation, over the medium term. - Rates of revascularization increase with WIfI stage. It was suggested that the classification is capable of predicting patient benefit from revascularization. |
Beropoulis et al.1818 Beropoulis E, Stavroulakis K, Schwindt A, Stachmann A, Torsello G, Bisdas T. Validation of the Wound, Ischemia, foot Infection (WIfI) classification system in nondiabetic patients treated by endovascular means for critical limb ischemia. J Vasc Surg. 2016;64(1):95-103. http://dx.doi.org/10.1016/j.jvs.2016.01.040. PMid:26994958. http://dx.doi.org/10.1016/j.jvs.2016.01....
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126 |
- Confirmed the prognostic value of the WIfI classification in relation to risk of amputation and death in non-diabetic patients treated with endovascular techniques. |
Ward et al.1919 Ward R, Dunn J, Clavijo L, Shavelle D, Rowe V, Woo K. Outcomes of Critical Limb Ischemia in an Urban, Safety Net Hospital Population with High WIfI Amputation Scores. Ann Vasc Surg. 2017;38:84-9. http://dx.doi.org/10.1016/j.avsg.2016.08.005. PMid:27546850. http://dx.doi.org/10.1016/j.avsg.2016.08...
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98 |
- Amputation rates increased as WIfI stage increased. |
- Revascularization significantly reduced the risk of amputation among patients at high risk of amputation at 1 year, classified by the WIfI. |
Darling et al.1414 Darling JD, McCallum JC, Soden PA, et al. Predictive ability of the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system after first-time lower extremity revascularizations. J Vasc Surg. 2017;65(3):695-704. http://dx.doi.org/10.1016/j.jvs.2016.09.055. PMid:28073665. http://dx.doi.org/10.1016/j.jvs.2016.09....
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992 |
- The study proposed two new scores to be used to complement or substitute the WIfI classification, the composite WIfI score and the mean WIfI score, because they were better predictors of the outcomes studied (mortality, risk of amputation, and RAS events), easier to administrate, and better for comparing results between patients. |
- The WIfI classification was a good predictor of major amputations and RAS events, but not of mortality. Only the new scores were consistent predictors of mortality in this study. |
- Patients revascularized for CLTI for the first time were at greater risk of a major amputation in the future, the higher their classification on any of the three scores used in the study. |
Robinson et al.2020 Robinson WP, Loretz L, Hanesian C, et al. Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) score correlates with the intensity of multimodal limb treatment and patient-centered outcomes in patients with threatened limbs managed in a limb preservation center. J Vasc Surg. 2017;66(2):488-98.e2. http://dx.doi.org/10.1016/j.jvs.2017.01.063. PMid:28410924. http://dx.doi.org/10.1016/j.jvs.2017.01....
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262 |
- Increases in WIfI stage were correlated with reductions in- AFS, but not with 1-year mortality. |
Mathioudakis et al.2121 Mathioudakis N, Hicks CW, Canner JK, et al. The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system predicts wound healing but not major amputation in patients with diabetic foot ulcers treated in a multidisciplinary setting. J Vasc Surg. 2017;65(6):1698-705.e. http://dx.doi.org/10.1016/j.jvs.2016.12.123. PMid:28274750. http://dx.doi.org/10.1016/j.jvs.2016.12....
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279 |
-According to the study, “Among patients with DFU, the WIfI classification system correlated well with wound healing but was not associated with risk of major amputation at 1 year”. |
- Argues that a multidisciplinary approach to DFUs could help to reduction risk of amputation in patients at stage4. |
Hicks et al.2222 Hicks CW, Canner JK, Mathioudakis N, et al. The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification independently predicts wound healing in diabetic foot ulcers. J Vasc Surg. 2018;68(4):1096-103. http://dx.doi.org/10.1016/j.jvs.2017.12.079. PMid:29622357. http://dx.doi.org/10.1016/j.jvs.2017.12....
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-The WIfI classification was capable of predicting healing of wounds at 1 year in patients with DFU. Mean healing time increased as WIfI stage increased. |
Van Haelst et al.2323 Van Haelst ST, Teraa M, Moll FL, Borst GJ, Verhaar MC, Conte MS. Prognostic value of the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification in patients with no-option chronic limb-threatening ischemia. J Vasc Surg. 2018;68(4):1104-13.e1. http://dx.doi.org/10.1016/j.jvs.2018.02.028. PMid:29802042. http://dx.doi.org/10.1016/j.jvs.2018.02....
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150 |
-In a subpopulation with CLTI, without revascularization options, the SVS WIfI classification correlated well with mortality, minor and major amputation, AFS, and wound healing. |
- The study suggested that stage 2 patients (WIfI 030) should be reallocated to stage 3 to better reflect the risk of amputation when revascularization is not an option. |