Trends of hospital admissions due to acute limb ischemia and venous thromboembolism in Austria: A population-wide observational analysis from 2009 to 2023.

OBJECTIVE

Thrombosis-related conditions account for approximately 25 % of global mortality, underlying major vascular emergencies such as acute limb ischemia (ALI) and venous thromboembolism (VTE). However, real-world data on long-term epidemiological trends remain limited. The present study aimed at investigating trends in the epidemiology of acute limb ischemia (ALI), pulmonary embolism (PE), and deep venous thrombosis (DVT).

METHODS

This retrospective population-based study analyzed hospital-admitted ALI and VTE in Austria between 2009 and 2023 using a federal inpatient database. Analyses included annual incidence and incidence rates, in-hospital mortality, comorbidities, major complications, and demographic characteristics for ALI, PE, and DVT cases.

RESULTS

Between 2009 and 2023 the Austrian population increased from 8.3 mio to 9.1 mio. Inhabitants, with the proportion of individuals of >65 years of age increasing from 17.4 % to 19.6 %. The incidence rate of ALI significantly declined from 27.2 per 100,000 to 13.6 per 100,000 over the study period (-50.0 %). The proportion of female ALI patients decreased over time, while the age distribution remained unchanged. The incidence of hospital-admitted VTE also declined, particularly for DVT, which saw a 73.9 % reduction. Hospital-admitted PE incidence decreased from 89.1 per 100.000 to 73.4 per 100.000 (-17.6 %), with in-hospital mortality declining from 8.9 % to 4.2 %. The duration of hospital stay decreased for both ALI and VTE, with most patients being discharged within nine days.

CONCLUSIONS

A substantial decline in the incidence of hospital-admitted ALI and VTE has been observed in Austria over the past 15 years, which may be consistent with improved cardiovascular risk management, encompassing the widespread adoption of DOACs and statins, a decline in daily smoking, increased outpatient management, and advancements in perioperative thromboprophylaxis.