TY - JOUR
T1 - Burden of hospitalization in clinically diagnosed peripheral artery disease
T2 - A community-based study
AU - Arruda-Olson, Adelaide M.
AU - Moussa Pacha, Homam
AU - Afzal, Naveed
AU - Abram, Sara
AU - Lewis, Bradley R.
AU - Isseh, Iyad
AU - Haddad, Raad
AU - Scott, Christopher G.
AU - Bailey, Kent
AU - Liu, Hongfang
AU - Rooke, Thom W.
AU - Kullo, Iftikhar J.
N1 - Publisher Copyright:
© 2017, © The Author(s) 2017.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - The burden and predictors of hospitalization over time in community-based patients with peripheral artery disease (PAD) have not been established. This study evaluates the frequency, reasons and predictors of hospitalization over time in community-based patients with PAD. We assembled an inception cohort of 1798 PAD cases from Olmsted County, MN, USA (mean age 71.2 years, 44% female) from 1 January 1998 through 31 December 2011 who were followed until 2014. Two age- and sex-matched controls (n = 3596) were identified for each case. ICD-9 codes were used to ascertain the primary reasons for hospitalization. Patients were censored at death or last follow-up. The most frequent reasons for hospitalization were non-cardiovascular: 68% of 8706 hospitalizations in cases and 78% of 8005 hospitalizations in controls. A total of 1533 (85%) cases and 2286 (64%) controls (p < 0.001) were hospitalized at least once; 1262 (70%) cases and 1588 (44%) controls (p < 0.001) ≥ two times. In adjusted models, age, prior hospitalization and comorbid conditions were independently associated with increased risk of recurrent hospitalizations in both groups. In cases, severe PAD (ankle–brachial index < 0.5) (HR: 1.25; 95% CI: 1.15, 1.36) and poorly compressible arteries (HR: 1.26; 95% CI: 1.16, 1.38) were each associated with increased risk for recurrent hospitalization. We demonstrate an increased rate of hospitalization in community-based patients with PAD and identify predictors of recurrent hospitalizations. These observations may inform strategies to reduce the burden of hospitalization of PAD patients.
AB - The burden and predictors of hospitalization over time in community-based patients with peripheral artery disease (PAD) have not been established. This study evaluates the frequency, reasons and predictors of hospitalization over time in community-based patients with PAD. We assembled an inception cohort of 1798 PAD cases from Olmsted County, MN, USA (mean age 71.2 years, 44% female) from 1 January 1998 through 31 December 2011 who were followed until 2014. Two age- and sex-matched controls (n = 3596) were identified for each case. ICD-9 codes were used to ascertain the primary reasons for hospitalization. Patients were censored at death or last follow-up. The most frequent reasons for hospitalization were non-cardiovascular: 68% of 8706 hospitalizations in cases and 78% of 8005 hospitalizations in controls. A total of 1533 (85%) cases and 2286 (64%) controls (p < 0.001) were hospitalized at least once; 1262 (70%) cases and 1588 (44%) controls (p < 0.001) ≥ two times. In adjusted models, age, prior hospitalization and comorbid conditions were independently associated with increased risk of recurrent hospitalizations in both groups. In cases, severe PAD (ankle–brachial index < 0.5) (HR: 1.25; 95% CI: 1.15, 1.36) and poorly compressible arteries (HR: 1.26; 95% CI: 1.16, 1.38) were each associated with increased risk for recurrent hospitalization. We demonstrate an increased rate of hospitalization in community-based patients with PAD and identify predictors of recurrent hospitalizations. These observations may inform strategies to reduce the burden of hospitalization of PAD patients.
KW - hospitalization
KW - peripheral artery disease (PAD)
KW - vascular medicine
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U2 - 10.1177/1358863X17736152
DO - 10.1177/1358863X17736152
M3 - Article
C2 - 29068255
AN - SCOPUS:85042857297
SN - 1358-863X
VL - 23
SP - 23
EP - 31
JO - Vascular Medicine (United Kingdom)
JF - Vascular Medicine (United Kingdom)
IS - 1
ER -