Time trends in incidence rates of acute, non-traumatic extremity ischaemia: a population-based study during a 19-year period

Acute occlusion of the arteries of the extremities can result in death rate of 15 to 60 percent; loss of limb may occur in 15 to 50 percent of these patients. Arterial occlusion is a late symptom of arteriosclerotic vascular disease and its incidence would be expected to increase with increasing age. In the past 30 years, an increase in thrombosis (clot formation) and a decrease in embolus (clot obstructing a distant artery) have been observed. There is little information on the epidemiology of acute arterial ischemia of the extremities. Using a patient register for all hospital admissions in a well-defined area of Sweden with a population of 1.3 million, a study was undertaken to determine trends in the incidence of acute extremity ischemia (inadequate blood supply to an extremity). Hospital admissions from 1965 and 1983 were studied. The number of first admissions for acute extremity ischemia increased steadily and significantly over the study period for both men and women. The annual number of first admissions increased by 2.7 percent for women and 3.9 percent for men; age-adjusted incidence remained stable for women, but for men increased 2.6 percent each year. A study of patients who underwent embolectomy (clot removal) surgery during this period revealed a 7.6 percent annual increase for women and 8.6 percent increase for men. The age-adjusted incidence rose 3.0 percent yearly for women and 7.5 percent for women. In both the population-based and surgical group, the age-related increase mostly occurred in patients 70 and over. This rise in incidence, despite an adjustment for age, may be the result of an increase in behaviors that promote arteriosclerotic disease (such as smoking) among those patients now reaching their 70's and 80's. (Consumer Summary produced by Reliance Medical Information, Inc.)