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Revascularizations and limb outcomes of hospitalized patients with diabetic peripheral arterial disease in the contemporary era.
- Source :
-
Journal of vascular surgery [J Vasc Surg] 2023 Apr; Vol. 77 (4), pp. 1155-1164.e2. Date of Electronic Publication: 2022 Dec 21. - Publication Year :
- 2023
-
Abstract
- Background: Concomitant diabetes mellitus and peripheral artery disease (PAD) is a complex disease process. This retrospective analysis of the National Inpatient Sample sought to understand trends in limb outcomes of this unique and prevalent cohort of patients.<br />Methods: The National Inpatient Sample was queried between 2003 and 2017 for hospitalizations of patients with both type 2 diabetes mellitus and PAD. Trends in hospitalizations, limb outcomes, vascular interventions, and costs were analyzed.<br />Results: There were 10,303,673 hospitalizations of patients with concomitant diabetes mellitus and PAD that were identified between 2003 and 2017. The prevalence of hospitalizations associated with this disease process increased from 1644 to 3228 per 100,000 hospitalizations, a 96.4% increase. This included an increase of 288 to 587 per 100,000 hospitalizations of patients aged 18 to 49 years old, which was accompanied by a 10.8% increase in minor amputations. Nontraumatic lower extremity amputations decreased overall. Black and Hispanic ethnicity were associated with an increased risk for amputation, along with Medicaid insurance and lower income quartile. Inpatient endovascular revascularization has increased over time with an associated decrease in open revascularization procedures. Amputation-related hospital costs significantly increased from $6.6 billion in 2003 to $14.8 billion in 2017.<br />Conclusions: An alarming increase of disease prevalence, negative in-hospital limb outcomes, and costs are seen in the current era in this analysis of patients with concurrent diabetes and PAD.<br /> (Copyright © 2022 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- United States epidemiology
Humans
Adolescent
Young Adult
Adult
Middle Aged
Retrospective Studies
Limb Salvage
Lower Extremity blood supply
Risk Factors
Treatment Outcome
Diabetes Mellitus, Type 2 complications
Diabetes Mellitus, Type 2 diagnosis
Diabetes Mellitus, Type 2 epidemiology
Endovascular Procedures
Diabetic Angiopathies diagnosis
Diabetic Angiopathies epidemiology
Diabetic Angiopathies surgery
Peripheral Arterial Disease diagnosis
Peripheral Arterial Disease epidemiology
Peripheral Arterial Disease surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6809
- Volume :
- 77
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 36563711
- Full Text :
- https://doi.org/10.1016/j.jvs.2022.12.016