Keller Karsten, Schmitt Volker H, Vosseler Markus, Brochhausen Christoph, Münzel Thomas, Hobohm Lukas, Espinola-Klein Christine
Department of Cardiology, Cardiology I, University Medical Center Mainz (Johannes Gutenberg-University Mainz), 55131 Mainz, Germany.
Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), 55131 Mainz, Germany.
J Clin Med. 2021 Oct 28;10(21):5033. doi: 10.3390/jcm10215033.
In patients with peripheral artery disease (PAD), the impact of diabetes mellitus (DM) on patient-profile and adverse in-hospital events is not well investigated.
The German nationwide inpatient sample 2005-2019 was used for this analysis. Hospitalized PAD patients were stratified for DM and the influence of DM on patient-profile and adverse in-hospital events was investigated.
Our study comprised 2,654,871 hospitalizations (54.3% aged ≥70 years, 36.7% females) of patients with PAD in Germany 2005-2019. Among these, 864,691 (32.6%) patients had DM and 76,716 (2.9%) died during hospitalization. Diabetic PAD patients revealed an aggravated cardiovascular profile (Charlson Comorbidity Index: 6.0 (5.0-8.0) vs. 4.0 (3.0-5.0), < 0.001). PAD patients with DM showed a higher rate of in-hospital mortality (3.5% vs. 2.6%, < 0.001), as well as major adverse cardiovascular and cerebrovascular events (MACCE, 4.7% vs. 3.3%, < 0.001) and had more often operated with amputation surgery (16.4% vs. 9.1%, < 0.001). DM was an independent predictor of in-hospital mortality (OR 1.077 (95%CI 1.060-1.093), < 0.001) and MACCE (OR 1.118 (95%CI 1.103-1.133), < 0.001). In addition, amputations were also associated with DM (OR 1.804 (95%CI 1.790-1.818)), < 0.001).
DM is associated with an unfavorable clinical patient-profile and higher risk for adverse events in PAD patients, including substantially increased in-hospital mortality as well as MACCE rate, and were more often associated with amputation surgeries.
在周围动脉疾病（PAD）患者中，糖尿病（DM）对患者特征和不良住院事件的影响尚未得到充分研究。
本分析使用了2005 - 2019年德国全国住院患者样本。将住院的PAD患者按是否患有DM进行分层，并研究DM对患者特征和不良住院事件的影响。
我们的研究纳入了2005 - 2019年德国2,654,871例PAD患者的住院病例（54.3%年龄≥70岁，36.7%为女性）。其中，864,691例（32.6%）患者患有DM，76,716例（2.9%）在住院期间死亡。糖尿病PAD患者的心血管状况更差（Charlson合并症指数：6.0（5.0 - 8.0）对4.0（3.0 - 5.0），<0.001）。患有DM的PAD患者住院死亡率更高（3.5%对2.6%，<0.001），主要心血管和脑血管不良事件（MACCE）发生率也更高（4.7%对3.3%，<0.001），且接受截肢手术的频率更高（16.4%对9.1%，<0.001）。DM是住院死亡率（OR 1.077（95%CI 1.060 - 1.093），<0.001）和MACCE（OR 1.118（95%CI 1.103 - 1.133），<0.001）的独立预测因素。此外，截肢也与DM相关（OR 1.804（95%CI 1.790 - 1.818）），<0.001）。
DM与PAD患者不良的临床特征以及不良事件的高风险相关，包括住院死亡率和MACCE率大幅增加，且更常与截肢手术相关。
