Department of Medical Research, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan, Taiwan.
BMC Public Health. 2013 Dec 1;13:1107. doi: 10.1186/1471-2458-13-1107.
BACKGROUND: Lower extremity (LE) peripheral artery disease (PAD), which is associated with a reduced quality of life and increased mortality from atherosclerotic cardio-/cerebro-vascular occlusion, is a significant public health problem, especial for an aging society such as that of Taiwan. METHODS: Specific datasets of the 2000-2011 nationwide inpatient databases were analyzed. Two inclusion criteria, including one of the major diagnosis codes of PAD and one of three categorical invasive treatments of LE PAD, were used consecutively to select cases diagnosed as LE PAD and receiving invasive treatment. The epidemiology of invasively-treated PAD in Taiwan was estimated, and the influences of potential confounders on these invasively-treated methods were evaluated. RESULTS: In general, the invasively-treated incidence of PAD in Taiwan doubled, from 3.73/10,000 (in 2000) to 7.48/10,000 (in 2011). On average, the total direct medical cost of one hospitalized and invasively-treated PAD case ranged from $US 4,600 to $US 5,900. The annual cases of bypass surgery for the PAD cases averaged 1,000 and the cases for limb amputation ranged from 4,100 to 5,100 annually. However, the number of percutaneous transluminal angioplasty (PTA) procedures remarkably increased by 15 times, from 600/year to 9,100/year, from 2000 to 2011. 51.3% of all the enrolled cases were treated with limb amputations, and female, young and middle-aged people (30-65 years of age), DM patients and those on a low income had a tendency to undergo amputation due to PAD. 37.6% of all the enrolled cases were treated with PTAs related to hypertension, cardiovascular disease, hyperlipidemia and catastrophic Illness. 2-year PTA failure rates of 22.13%, 11.91% and 10.61% were noted among the first (2000-2001), second (2004-2005) and the third (2008-2009) cohort groups, respectively. CONCLUSIONS: In Taiwan, a gender difference and age and period effects on the invasively-treated incidence of LE PAD were observed. Female, young and middle-aged people (30-50 and 50-65 years of age), DM patients and those on a low income had a tendency to undergo amputation. The number of PTA procedures remarkably increased, but the 2-year failure rate of PTAs reduced from 2000 to 2011.
背景：下肢动脉疾病（PAD）会降低生活质量，并增加动脉粥样硬化性心脑血管闭塞导致的死亡率，是一个严重的公共卫生问题，尤其是在像台湾这样的老龄化社会。
方法：分析了 2000 年至 2011 年全国住院患者数据库的特定数据集。连续使用两个纳入标准，包括 PAD 的主要诊断代码之一和下肢 PAD 的三种分类侵入性治疗之一，以选择诊断为下肢 PAD 并接受侵入性治疗的病例。估计了台湾接受侵入性治疗的 PAD 的流行病学，并评估了潜在混杂因素对这些侵入性治疗方法的影响。
结果：总体而言，台湾接受侵入性治疗的 PAD 发病率增加了一倍，从 2000 年的 3.73/10000 增加到 2011 年的 7.48/10000。平均而言，每位住院接受侵入性治疗的 PAD 患者的直接医疗费用在 4600 美元至 5900 美元之间。PAD 患者每年进行旁路手术的病例平均为 1000 例，截肢病例每年从 4100 例到 5100 例不等。然而，经皮腔内血管成形术（PTA）的数量却显著增加了 15 倍，从 2000 年的 600 例/年增加到 9100 例/年。所有纳入病例中，51.3%接受了截肢治疗，女性、年轻和中年（30-65 岁）、糖尿病患者和低收入者因 PAD 有截肢的倾向。所有纳入病例中，有 37.6%接受了与高血压、心血管疾病、高血脂和灾难性疾病相关的 PTA 治疗。第一（2000-2001 年）、第二（2004-2005 年）和第三（2008-2009 年）队列组中，2 年 PTA 失败率分别为 22.13%、11.91%和 10.61%。
结论：在台湾，观察到下肢 PAD 接受侵入性治疗的发病率存在性别差异和年龄和时期效应。女性、年轻和中年（30-50 岁和 50-65 岁）、糖尿病患者和低收入者有截肢的倾向。PTA 手术数量显著增加，但 2000 年至 2011 年，PTA 的 2 年失败率有所下降。
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