Optimization of management of patients with critical lower limb ischemia, allowing for risk of gangrene
Aim. To develop mathematical models for predicting the risk of gangrene of the lower limb and the algorithm for selecting of treatment strategies for vascular surgeons and angiologists.Material and methods. The results presented in this work are based on a six-year-old (since 2011) observation of 40...
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| Format: | Article |
| Language: | Russian |
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«SILICEA-POLIGRAF» LLC
2019-04-01
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| Series: | Кардиоваскулярная терапия и профилактика |
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| Online Access: | https://cardiovascular.elpub.ru/jour/article/view/677 |
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| author | A. V. Bykov N. A. Korenevsky S. A. Parkhomenko I. I. Khripina |
| author_facet | A. V. Bykov N. A. Korenevsky S. A. Parkhomenko I. I. Khripina |
| author_sort | A. V. Bykov |
| collection | DOAJ |
| description | Aim. To develop mathematical models for predicting the risk of gangrene of the lower limb and the algorithm for selecting of treatment strategies for vascular surgeons and angiologists.Material and methods. The results presented in this work are based on a six-year-old (since 2011) observation of 400 patients with chronic obliterating diseases of the lower limb arteries, some of which had combinations of ischemic damage to the central hemodynamic system, heart and brain. Patients had different stages of the disease, up to critical ischemia and gangrene, which requires amputation of the lower limbs. During the exploratory analysis, we selected 8 informative features, which were used to develop mathematical models that divide patients into classes: low confidence in the development of gangrene; average confidence in the development of gangrene; high confidence in the development of gangrene and very high confidence in the development of gangrene. For each identified class, confidence in the development of gangrene was determined by an individual treatment strategy, implemented in accordance with the intelligent decision support system by a decision-making algorithm.Results. It was shown that, compared with traditional treatment tactics, using of presented algorithm can increase the speed of positive results achieving by 3,4 times (68,3%), reduce the risk of lower limb gangrene development by 2,8 times (61,6%) and reduce the risk of limb amputation by 4,1 times (68,1%).Conclusion. The obtained mathematical models should be used in the medical practice of vascular surgeons and angiologists, both in the form of software for smartphones and tablet computers, and as part of decision support systems, including telemedicine systems. |
| format | Article |
| id | doaj-art-daaf1cf5047a4c378660c7037ff41fdf |
| institution | Kabale University |
| issn | 1728-8800 2619-0125 |
| language | Russian |
| publishDate | 2019-04-01 |
| publisher | «SILICEA-POLIGRAF» LLC |
| record_format | Article |
| series | Кардиоваскулярная терапия и профилактика |
| spelling | doaj-art-daaf1cf5047a4c378660c7037ff41fdf2025-08-20T03:35:47Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252019-04-01182384410.15829/1728-8800-2019-2-38-441911Optimization of management of patients with critical lower limb ischemia, allowing for risk of gangreneA. V. Bykov0N. A. Korenevsky1S. A. Parkhomenko2I. I. Khripina3Kursk Regional HospitalSouthwest State UniversityCentral Military Clinical Hospital named after A. A. VishnevskySouthwest State UniversityAim. To develop mathematical models for predicting the risk of gangrene of the lower limb and the algorithm for selecting of treatment strategies for vascular surgeons and angiologists.Material and methods. The results presented in this work are based on a six-year-old (since 2011) observation of 400 patients with chronic obliterating diseases of the lower limb arteries, some of which had combinations of ischemic damage to the central hemodynamic system, heart and brain. Patients had different stages of the disease, up to critical ischemia and gangrene, which requires amputation of the lower limbs. During the exploratory analysis, we selected 8 informative features, which were used to develop mathematical models that divide patients into classes: low confidence in the development of gangrene; average confidence in the development of gangrene; high confidence in the development of gangrene and very high confidence in the development of gangrene. For each identified class, confidence in the development of gangrene was determined by an individual treatment strategy, implemented in accordance with the intelligent decision support system by a decision-making algorithm.Results. It was shown that, compared with traditional treatment tactics, using of presented algorithm can increase the speed of positive results achieving by 3,4 times (68,3%), reduce the risk of lower limb gangrene development by 2,8 times (61,6%) and reduce the risk of limb amputation by 4,1 times (68,1%).Conclusion. The obtained mathematical models should be used in the medical practice of vascular surgeons and angiologists, both in the form of software for smartphones and tablet computers, and as part of decision support systems, including telemedicine systems.https://cardiovascular.elpub.ru/jour/article/view/677critical lower limb ischemiagangrenefuzzy mathematical modelsan algorithm for selecting of treatment strategies |
| spellingShingle | A. V. Bykov N. A. Korenevsky S. A. Parkhomenko I. I. Khripina Optimization of management of patients with critical lower limb ischemia, allowing for risk of gangrene Кардиоваскулярная терапия и профилактика critical lower limb ischemia gangrene fuzzy mathematical models an algorithm for selecting of treatment strategies |
| title | Optimization of management of patients with critical lower limb ischemia, allowing for risk of gangrene |
| title_full | Optimization of management of patients with critical lower limb ischemia, allowing for risk of gangrene |
| title_fullStr | Optimization of management of patients with critical lower limb ischemia, allowing for risk of gangrene |
| title_full_unstemmed | Optimization of management of patients with critical lower limb ischemia, allowing for risk of gangrene |
| title_short | Optimization of management of patients with critical lower limb ischemia, allowing for risk of gangrene |
| title_sort | optimization of management of patients with critical lower limb ischemia allowing for risk of gangrene |
| topic | critical lower limb ischemia gangrene fuzzy mathematical models an algorithm for selecting of treatment strategies |
| url | https://cardiovascular.elpub.ru/jour/article/view/677 |
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