Long-term survival after initial hospital admission for peripheral arterial disease in the lower extremities.
BACKGROUND
As the population ages, peripheral arterial disease (PAD) in the lower extremities will become a larger public health problem. Awareness in patients as well clinicians of the high risk of morbidity and mortality is important but seems currently low. Insights in absolute mortality risks following admission for PAD in the lower extremities can be useful to improve awareness as they are easy to interpret.


METHODS
A nationwide cohort of 4,158 patients with an initial admission for PAD in the lower extremities was identified through linkage of the national hospital and population register in 1997 and 2000.


RESULTS
Over 60% of 4,158 patients were men. 28 days, 1 year and 5 year mortality risk were 2.4%, 10.3% and 31.0% for men and 3.5%, 10.4% and 27.4% for women. Coronary heart disease and stroke were frequent cause of death. Five years mortality risk was higher for men compared to women (HR 1.36, 95% CI 1.21-1.53).


CONCLUSIONS
In conclusion, our findings demonstrate that, 5 year mortality risk is high, especially in men and comparable to that of patients admitted for acute myocardial infarction or ischemic stroke. Though, in general population the awareness of the severity of PAD in the lower extremities is significantly lower than that for any other cardiovascular disease and it seems that cardiovascular risk factor management for prevention in PAD patients is very modest.
Vaartjes
I
I
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. c.h.vaartjes@umcutrecht.nl
de Borst
G J
GJ
Reitsma
J B
JB
de Bruin
A
A
Moll
F L
FL
Grobbee
D E
DE
Bots
M L
ML
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control*; D002423:Cause of Death; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome