Assessment of the burden of disease for patients with peripheral artery disease undergoing revascularization in England. (October 2022)

• Record Type: Journal Article
• Authors: Portas, Laura; Bauersachs, Rupert; Bowrin, Kevin; Briere, Jean-Baptiste; Cohen, Alexander; Huelsebeck, Maria; Jones, Schuyler; Quint, Jennifer K
• Is Part Of: Vascular medicine. Volume 27:Number 5(2022)
• Page Start: 440
• Page End: 449
• Publication Date: 2022-10
• Subjects: lower-limb revascularization -- peripheral artery disease (PAD) -- healthcare resource utilization; Blood-vessels -- Diseases -- Periodicals; Peripheral vascular diseases -- Periodicals; Vascular Diseases -- Periodicals; Vaisseaux sanguins -- Maladies -- Périodiques; Maladies vasculaires périphériques -- Périodiques; 616.13
• DOI: 10.1177/1358863X221096704
• Languages: English
• ISSNs: 1358-863X

Abstract

Background: Symptoms, severity, and acuteness of peripheral artery disease (PAD) are major determinants of severe limb symptoms, subsequent risk of cardiovascular events, and mortality. Lower-extremity revascularization (LER) is a key option to relieve symptoms and to prevent limb loss in symptomatic patients with PAD. This study aimed to quantify the burden of disease among patients with PAD-LER in England.Methods: A retrospective population-based study of linked primary and secondary care electronic health records, included 13, 869 adult patients (aged ⩾ 18 years) with PAD-LER from 2003 to 2018. The incidence of first ever PAD-LER was estimated both overall and by type of procedure (endovascular/surgical). Health resource utilization associated with PAD-related complications and treatment patterns were assessed.Results: A high annual incidence of lower-limb revascularization (41.2 per 1000 person years) and a nearly double incidence of endovascular first revascularization compared with open surgery were observed. More than 70% of patients with PAD-LER had a history of hyperlipidemia and hypertension and roughly one-third were diabetic and had a history of coronary artery disease. Cardiovascular mortality accounted for one-third (34.1 per 1000 person years) of all-cause mortality. Over 93% of patients were hospitalized for any reason and the commonest reasons for hospitalization were cardiovascular diseases and PAD with about one-third hospitalized for revascularization reoccurrence.Conclusion: There is a significant burden of PAD-LER to the individual and society with ongoing healthcare resource utilization, treatment, and increasing mortality.