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评估英国接受血运重建的外周动脉疾病患者的疾病负担。

Assessment of the burden of disease for patients with peripheral artery disease undergoing revascularization in England.

机构信息

National Heart and Lung Institute, Imperial College London, London, UK.

Department of Vascular Medicine - Angiology, Klinikum Darmstadt, Darmstadt, Germany.

出版信息

Vasc Med. 2022 Oct;27(5):440-449. doi: 10.1177/1358863X221096704. Epub 2022 Jun 7.

DOI:10.1177/1358863X221096704
PMID:35670290
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9551319/
Abstract

Symptoms, severity, and acuteness of peripheral artery disease (PAD) are major determinants of severe limb symptoms, subsequent risk of cardiovascular events, and mortality. Lower-extremity revascularization (LER) is a key option to relieve symptoms and to prevent limb loss in symptomatic patients with PAD. This study aimed to quantify the burden of disease among patients with PAD-LER in England. A retrospective population-based study of linked primary and secondary care electronic health records, included 13,869 adult patients (aged ⩾ 18 years) with PAD-LER from 2003 to 2018. The incidence of first ever PAD-LER was estimated both overall and by type of procedure (endovascular/surgical). Health resource utilization associated with PAD-related complications and treatment patterns were assessed. A high annual incidence of lower-limb revascularization (41.2 per 1000 person years) and a nearly double incidence of endovascular first revascularization compared with open surgery were observed. More than 70% of patients with PAD-LER had a history of hyperlipidemia and hypertension and roughly one-third were diabetic and had a history of coronary artery disease. Cardiovascular mortality accounted for one-third (34.1 per 1000 person years) of all-cause mortality. Over 93% of patients were hospitalized for any reason and the commonest reasons for hospitalization were cardiovascular diseases and PAD with about one-third hospitalized for revascularization reoccurrence. There is a significant burden of PAD-LER to the individual and society with ongoing healthcare resource utilization, treatment, and increasing mortality.

摘要

外周动脉疾病(PAD)的症状、严重程度和急性程度是严重肢体症状、随后心血管事件风险和死亡率的主要决定因素。下肢血运重建(LER)是缓解症状和预防有症状 PAD 患者肢体丧失的关键选择。本研究旨在量化英国 PAD-LER 患者的疾病负担。

一项回顾性基于人群的初级和二级保健电子健康记录关联研究,纳入了 2003 年至 2018 年间 13869 名患有 PAD-LER 的成年患者(年龄 ⩾18 岁)。总体上和按手术类型(血管内/手术)分别估计首次 PAD-LER 的发病率。评估了与 PAD 相关并发症和治疗模式相关的卫生资源利用情况。

下肢血运重建的年发病率很高(41.2/1000 人年),与开放手术相比,首次血管内血运重建的发病率几乎翻了一番。超过 70%的 PAD-LER 患者有高脂血症和高血压病史,大约三分之一的患者患有糖尿病且有冠状动脉疾病病史。心血管死亡率占全因死亡率的三分之一(34.1/1000 人年)。超过 93%的患者因任何原因住院,最常见的住院原因是心血管疾病和 PAD,约三分之一的患者因血运重建再发住院。

PAD-LER 对个人和社会造成了重大的疾病负担,持续的医疗保健资源利用、治疗和不断增加的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c984/9551319/316de5580fdd/10.1177_1358863X221096704-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c984/9551319/3b65934eb0ab/10.1177_1358863X221096704-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c984/9551319/316de5580fdd/10.1177_1358863X221096704-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c984/9551319/3b65934eb0ab/10.1177_1358863X221096704-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c984/9551319/316de5580fdd/10.1177_1358863X221096704-fig2.jpg

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