title: Aging and Outcome in Patients With Peripheral Artery Disease and Critical Limb Ischemia.
abstract: Aging of the population is one of the major challenges facing public health systems. The impact of aging on acute and long-term outcome of patients with peripheral artery disease (PAD) and critical limb ischemia (CLI) is currently not sufficiently clarified. This analysis consists of comprehensive, anonymized data obtained from the largest public health insurance in Germany.
  
  
  
  A total of 41,740 PAD patients with an index hospitalization between January 1, 2009, and December 31, 2011, and a follow-up time up to 4 years were included (40-49 years: n = 1179; 50-59 years: n = 5415; 60-69 years: n = 10,565; 70-79 years: n = 13,313; 80-89 years: n = 9714; and 90-100 years: n = 1554). Advanced age was associated with female gender (men-women ratio up to 1:3.3), less smoking, less frequent obesity, more often chronic heart failure (up to 9-fold), chronic kidney disease (up to 4-fold), fewer angiographies (up to 0.8-fold), fewer endovascular (up to 0.5-fold) and surgical revascularizations (up to 0.9-fold), higher rates of amputation (up to 2.5-fold), acute renal failure (up to 3.7-fold), in-hospital mortality (up to 12-fold), myocardial infarction (up to 2.8-fold), ischemic stroke (up to 1.5-fold), infection (up to 1.4-fold), and sepsis (up to 1.8-fold) (each P < .001). During follow-up, advanced age was a highly significant independent predictor of long-term mortality, myocardial infarction, and stroke (each P < .001). Lengths of hospital stay (up to 1.3-fold longer) and reimbursement costs (up to 1.1-fold higher) were clearly associated with advanced age (each P < .001).
  
  
  
  This study demonstrates the impact of aging on morbidity, in-hospital treatment, complications, and acute and long-term outcome of PAD patients.
authors.affiliation: Faculty of Social Science, Institute of Sociology, University of Duisburg Essen, Duisburg, Germany; Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.
authors.forename: Saskia
authors.initials: S
authors.lastname: Skonetzki
authors.affiliation: Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany. Electronic address: florian.lueders@ukmuenster.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Lüders
authors.affiliation: Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Engelbertz
authors.affiliation: Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.
authors.forename: Nasser M
authors.initials: NM
authors.lastname: Malyar
authors.affiliation: Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Freisinger
authors.affiliation: Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Meyborg
authors.affiliation: Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Reinecke
mesh_terms: D000067575:Administrative Claims, Healthcare; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000671:Amputation, Surgical; D005260:Female; D005858:Germany; D017048:Health Care Costs; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007511:Ischemia / Q000191:economics / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D058729:Peripheral Arterial Disease / Q000191:economics / Q000601:surgery
keywords: Peripheral artery disease; age distribution; amputation; critical limb ischemia; economic impact; endovascular procedures; outcome; vascular surgical procedures