Ionac Stefan, Rogers Steven K, Bondor Cosmina I, Bowling Frank L, Dragoi Iulia Iovanca, Ionac Mihai
CerVasc, Vascular and Endovascular Surgery Research Center, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Piata Eftimie Murgu 2, 300041 Timisoara, Romania.
School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK.
J Clin Med. 2023 Dec 21;13(1):52. doi: 10.3390/jcm13010052.
(1) Background: This retrospective Romanian study aimed to calculate the rate of, and comparison between, amputation and revascularisation for patients with either cardiovascular or diabetic comorbidities. (2) Materials: In our hospital-based database, we analysed patient-level data from a series of 61 hospitals for 2019, which covers 44.9% of the amputation patients for that year. The national database is compiled by the national houses of insurance and was used to follow amputations and revascularisations between 2016 and 2021. (3) Results: During the six-year period, the mean number of amputations and revascularisations was 72.4 per 100,000 inhabitants per year for both groups. In this period, a decline in open-surgical revascularisation was observed from 58.3% to 47.5% in all interventions but was not statistically significant (r = -0.20, = 0.70). The mean age of patients with amputation (hospital-based database) was 67 years. Of these patients, only 5.1% underwent revascularisation in the same hospital prior to amputation. The most common comorbidities in those undergoing amputations were peripheral arterial disease (76.8%), diabetes (60.8%), and arterial hypertension (53.5%). Most amputations were undertaken by general surgeons (73.0%) and only a small number of patients were treated by vascular surgeons (17.4%). (4) Conclusions: The signal from our data indicates that Romanian patients probably have a high risk of amputation > 5 years earlier than Western European countries, such as Denmark, Finland, and Germany. The prevalence of revascularisations in Romania is 64% lower than in the Western European countries.
(1) 背景：这项罗马尼亚的回顾性研究旨在计算患有心血管或糖尿病合并症患者的截肢率以及截肢与血管再通之间的比较情况。(2) 材料：在我们基于医院的数据库中，我们分析了2019年来自61家医院的患者层面数据，该数据涵盖了当年44.9%的截肢患者。国家数据库由国家保险机构汇编，用于追踪2016年至2021年期间的截肢和血管再通情况。(3) 结果：在这六年期间，两组每年每10万居民的平均截肢和血管再通数量均为72.4例。在此期间，在所有干预措施中，开放手术血管再通率从58.3%降至47.5%，但差异无统计学意义（r = -0.20，P = 0.70）。截肢患者（基于医院数据库）的平均年龄为67岁。在这些患者中，只有5.1%在截肢前在同一家医院接受了血管再通治疗。接受截肢手术患者中最常见的合并症是外周动脉疾病（76.8%）、糖尿病（60.8%）和动脉高血压（53.5%）。大多数截肢手术由普通外科医生进行（73.0%），只有少数患者由血管外科医生治疗（17.4%）。(4) 结论：我们数据显示的迹象表明，罗马尼亚患者截肢风险可能比丹麦、芬兰和德国等西欧国家早5年以上。罗马尼亚血管再通的患病率比西欧国家低64%。
