Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.
Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, USA.
Eur Radiol. 2022 Mar;32(3):1697-1708. doi: 10.1007/s00330-021-08285-y. Epub 2021 Oct 13.
To analyze trends of in-hospital treatment of patients admitted due to peripheral artery disease (PAD) from 2009 to 2018 with special focus on comorbidities, revascularization procedures, resulting costs, and outcome.
Using data from the research data center of the German Federal Statistical Office, we included all hospitalizations due to PAD Fontaine stage IIb or higher from 2009 to 2018. To analyze comorbidities, Elixhauser diagnostic groups and linear van Walraven score (vWS) were assessed.
A total of 1.8 million hospitalizations resulting in €10.3 billion in reimbursement costs were included. From 2009 to 2018, the absolute number of hospitalizations due to PAD increased by 13.3% (163,547 to 185,352). The average cost per hospitalization increased by 20.8% from €5,261 to €6,356. The overall in-hospital mortality decreased from 3.1 to 2.6%. Median vWS of all PAD cases increased by 3 points (2 to 5). The number of percutaneous transluminal angioplasties (PTA) increased by 43.9% while some surgical procedures such as bypasses and embolectomies decreased by 30.8% and 6.8%, respectively. Many revascularization procedures showed a disproportionate increase of those performed in vessels below the knee for example in PTA (+ 68.5%) or in endarterectomies (+ 38.8%).
This decade-long nationwide analysis shows a rising number of hospitalizations due to PAD with more comorbid patients resulting in increasing reimbursement costs. Interventions are shifting from surgical to endovascular approaches with a notable trend towards interventions in smaller vessels below the knee.
• The number of hospitalizations due to peripheral artery disease is rising and it is associated with increasing reimbursement costs. • Admitted patients are older and show an increasing number of comorbidities while overall in-hospital mortality is decreasing. • Revascularization procedures are shifting from surgical to endovascular approaches and show a trend towards intervention in smaller vessels below the knee. • Major amputations are decreasing while the number of minor amputations is increasing.
分析 2009 年至 2018 年因外周动脉疾病（PAD）入院治疗患者的住院治疗趋势，重点关注合并症、血运重建手术、相关费用和治疗结果。
利用德国联邦统计局研究数据中心的数据，我们纳入了 2009 年至 2018 年所有因 PADFontaine Ⅱb 期及以上住院的患者。为了分析合并症，我们评估了 Elixhauser 诊断组和线性 van Walraven 评分（vWS）。
共纳入 180 万例因 PAD 住院治疗的患者，总费用为 103 亿欧元。2009 年至 2018 年，因 PAD 住院的绝对人数增加了 13.3%（从 163547 例增加至 185352 例）。每次住院的平均费用从 5261 欧元增加至 6356 欧元，增加了 20.8%。全因住院死亡率从 3.1%降至 2.6%。所有 PAD 患者的中位 vWS 增加了 3 分（从 2 分增至 5 分）。经皮腔内血管成形术（PTA）的数量增加了 43.9%，而一些手术如旁路和取栓术则分别减少了 30.8%和 6.8%。许多血运重建手术，例如 PTA（增加了 68.5%）或内膜切除术（增加了 38.8%），在膝盖以下的血管中的比例显著增加。
这项长达十年的全国性分析显示，因 PAD 住院的人数不断增加，合并症患者越来越多，导致报销费用不断增加。治疗方式正在从手术转向血管内治疗，膝盖以下较小血管的介入治疗呈明显上升趋势。
外周动脉疾病住院人数不断增加，与报销费用的增加相关。
入院患者年龄更大，合并症更多，而总体住院死亡率呈下降趋势。
血运重建手术正在从手术转向血管内治疗，且膝盖以下较小血管的介入治疗呈上升趋势。
大截肢术的数量减少，而小截肢术的数量增加。
