Nasser M Malyar1, Eva Freisinger2, Matthias Meyborg2, Florian Lüders2, Torsten Fürstenberg3, Knut Kröger4, Giovanni Torsello5, Holger Reinecke2. 1. Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital of Muenster, Germany nasser.malyar@ukmuenster.de. 2. Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital of Muenster, Germany. 3. IGES Institut GmbH, Berlin, Germany. 4. Department of Angiology, Helios Klinikum Krefeld, Krefeld, Germany. 5. Center for Vascular and Endovascular Surgery, University Hospital of Muenster, Germany.
Abstract
BACKGROUND: To assess the nationwide contemporary burden of cardiovascular risk factors, comorbidities, and in-hospital mortality in patients with lower limb amputation (LLA) due to peripheral arterial disease and critical limb ischemia (CLI) in Germany. METHODS: German nationwide data for 2005 and 2009 were analyzed regarding in-hospital rates of major and minor ischemic LLA, risk factors, comorbidities, surgical and endovascular revascularizations, and in-hospital mortality. RESULTS: In 2005, a total of 22 479 major (7.8%) and 28 262 minor (9.8%) LLAs were performed with a relative decrease of -21.8% in major LLA, yet with a relative increase of +2% in minor LLA rate in 2009. The overall revascularization rate before amputation was 46% in 2005 and 57% in 2009. In-hospital mortality for non-CLI, minor, and major amputees was 3.3%, 4.6%, and 19.8%, respectively (P < .001 for major vs minor LLA and non-CLI). CONCLUSION: The total number of ischemic LLA and amputation-related in-hospital mortality remains high in Germany in the 21st century. The poor outcome of patients with CLI might in part be due to underuse of revascularizations prior to amputation.
BACKGROUND: To assess the nationwide contemporary burden of cardiovascular risk factors, comorbidities, and in-hospital mortality in patients with lower limb amputation (LLA) due to peripheral arterial disease and critical limb ischemia (CLI) in Germany. METHODS: German nationwide data for 2005 and 2009 were analyzed regarding in-hospital rates of major and minor ischemic LLA, risk factors, comorbidities, surgical and endovascular revascularizations, and in-hospital mortality. RESULTS: In 2005, a total of 22 479 major (7.8%) and 28 262 minor (9.8%) LLAs were performed with a relative decrease of -21.8% in major LLA, yet with a relative increase of +2% in minor LLA rate in 2009. The overall revascularization rate before amputation was 46% in 2005 and 57% in 2009. In-hospital mortality for non-CLI, minor, and major amputees was 3.3%, 4.6%, and 19.8%, respectively (P < .001 for major vs minor LLA and non-CLI). CONCLUSION: The total number of ischemic LLA and amputation-related in-hospital mortality remains high in Germany in the 21st century. The poor outcome of patients with CLI might in part be due to underuse of revascularizations prior to amputation.
Authors: Chloé Ml Peters; Jolanda de Vries; Eelco J Veen; Hans Gw de Groot; Gwan H Ho; Paul Lodder; Stijn L Steunenberg; Lijckle van der Laan Journal: Clin Interv Aging Date: 2019-07-02 Impact factor: 4.458
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