Burden of hospitalization in clinically diagnosed peripheral artery disease: A community-based study

Adelaide M Arruda-Olson, Homam Moussa Pacha, Naveed Afzal, Sara Abram, Bradley R. Lewis, Iyad Isseh, Raad Haddad, Christopher G. Scott, Kent R Bailey, Hongfang D Liu, Thom W Rooke, Iftikhar Jan Kullo

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)23-31
Number of pages9
JournalVascular Medicine (United Kingdom)
Volume23
Issue number1
DOIs
StatePublished - Feb 1 2018

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Peripheral Arterial Disease
Hospitalization
International Classification of Diseases
Arteries

Keywords

  • hospitalization
  • peripheral artery disease (PAD)
  • vascular medicine

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Burden of hospitalization in clinically diagnosed peripheral artery disease : A community-based study. / Arruda-Olson, Adelaide M; Moussa Pacha, Homam; Afzal, Naveed; Abram, Sara; Lewis, Bradley R.; Isseh, Iyad; Haddad, Raad; Scott, Christopher G.; Bailey, Kent R; Liu, Hongfang D; Rooke, Thom W; Kullo, Iftikhar Jan.

In: Vascular Medicine (United Kingdom), Vol. 23, No. 1, 01.02.2018, p. 23-31.

Research output: Contribution to journalArticle

Arruda-Olson, Adelaide M ; Moussa Pacha, Homam ; Afzal, Naveed ; Abram, Sara ; Lewis, Bradley R. ; Isseh, Iyad ; Haddad, Raad ; Scott, Christopher G. ; Bailey, Kent R ; Liu, Hongfang D ; Rooke, Thom W ; Kullo, Iftikhar Jan. / Burden of hospitalization in clinically diagnosed peripheral artery disease : A community-based study. In: Vascular Medicine (United Kingdom). 2018 ; Vol. 23, No. 1. pp. 23-31.
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abstract = "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.",
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