Malyar Nasser M, Freisinger Eva, Meyborg Matthias, Lüders Florian, Fürstenberg Torsten, Kröger Knut, Torsello Giovanni, Reinecke Holger
Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital of Muenster, Germany
Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital of Muenster, Germany.
Angiology. 2016 Oct;67(9):860-9. doi: 10.1177/0003319715626849. Epub 2016 Jan 13.
To assess the nationwide contemporary burden of cardiovascular risk factors, comorbidities, and in-hospital mortality in patients with lower limb amputation (LLA) due to peripheral arterial disease and critical limb ischemia (CLI) in Germany.
German nationwide data for 2005 and 2009 were analyzed regarding in-hospital rates of major and minor ischemic LLA, risk factors, comorbidities, surgical and endovascular revascularizations, and in-hospital mortality.
In 2005, a total of 22 479 major (7.8%) and 28 262 minor (9.8%) LLAs were performed with a relative decrease of -21.8% in major LLA, yet with a relative increase of +2% in minor LLA rate in 2009. The overall revascularization rate before amputation was 46% in 2005 and 57% in 2009. In-hospital mortality for non-CLI, minor, and major amputees was 3.3%, 4.6%, and 19.8%, respectively (P < .001 for major vs minor LLA and non-CLI).
The total number of ischemic LLA and amputation-related in-hospital mortality remains high in Germany in the 21st century. The poor outcome of patients with CLI might in part be due to underuse of revascularizations prior to amputation.
评估德国因外周动脉疾病和严重肢体缺血（CLI）导致下肢截肢（LLA）患者的全国性心血管危险因素、合并症及住院死亡率的当代负担。
分析2005年和2009年德国全国范围内关于严重和轻微缺血性LLA的住院率、危险因素、合并症、外科和血管内血运重建以及住院死亡率的数据。
2005年共进行了22479例严重LLA（7.8%）和28262例轻微LLA（9.8%），2009年严重LLA相对下降了-21.8%，而轻微LLA率相对上升了+2%。截肢前的总体血运重建率在2005年为46%，在2009年为57%。非CLI、轻微和严重截肢患者的住院死亡率分别为3.3%、4.6%和19.8%（严重LLA与轻微LLA及非CLI相比，P <.001）。
在21世纪的德国，缺血性LLA总数及与截肢相关的住院死亡率仍然很高。CLI患者预后较差可能部分归因于截肢前血运重建的使用不足。
