期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 60, 期 21, 页码 2230-2236出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2012.08.983
关键词
critical limb ischemia; geographic variation; lower-extremity amputation; peripheral artery disease
资金
- Duke Clinical Research Institute
- Agency for Healthcare Research and Quality [U19HS021092]
- Johnson Johnson
- Pluristem
- Astra Zeneca
- Bristol Myers Squibb-Sanofi
- Merck
- Eli Lilly
Objectives This study sought to characterize temporal trends, patient-specific factors, and geographic variation associated with amputation in patients with lower-extremity peripheral artery disease (LE PAD) during the study period. Background Amputation represents the end-stage failure for those with LE PAD, and little is known about the rates and geographic variation in the use of LE amputation. Methods By using data from the Centers for Medicare & Medicaid Services (CMS) from January 1, 2000, to December 31, 2008, we examined national patterns of LE amputation among patients age 65 years or more with PAD. Multivariable logistic regression was used to adjust regional results for other patient demographic and clinical factors. Results Among 2,730,742 older patients with identified PAD, the overall rate of LE amputation decreased from 7,258 per 100,000 patients with PAD to 5,790 per 100,000 (p < 0.001 for trend). Male sex, black race, diabetes mellitus, and renal disease were all independent predictors of LE amputation. The adjusted odds ratio of LE amputation per year between 2000 and 2008 was 0.95 (95% CI: 0.95-0.95, p < 0.001). Conclusions From 2000 to 2008, LE amputation rates decreased significantly among patients with PAD. However, there remains significant patient and geographic variation in amputation rates across the United States. (J Am Coll Cardiol 2012;60:2230-6) (C) 2012 by the American College of Cardiology Foundation
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据