Abstract
Abstract 16369: Trends in Hospitalization, Management and Clinical Outcomes Among Veterans With Critical Limb Ischemia
Circulation (New York, N.Y.), Vol.138(Suppl_1 Suppl 1), pp.A16369-A16369
11/06/2018
DOI: 10.1161/circ.138.suppl_1.16369
Abstract
BackgroundCritical limb ischemia (CLI) is the most severe presentation of peripheral arterial disease. Contemporary trends in the incidence, clinical characteristics, management and outcomes among Veterans with CLI remain unknown.MethodsWe used the Veterans Health Administration (VHA) database to identify Veterans admitted with CLI from 2005 to 2014. We examined calendar-year trends in the incidence, clinical characteristics, management and clinical outcomes in Veterans with CLI.ResultsOur study cohort included 23,777 patients. Annual incidence of CLI admission among VA population decreased from 0.35 per 1000 Veterans in 2005 to 0.18 per 1000 Veterans in 2013, p <0.01. Mean age for CLI patients increased during this period (Table1). Among study patients, there was a temporal decrease in the prevalence of diabetes, coronary artery disease, and heart failure but increase in the prevalence of renal disease (P < 0.01 for all). Although prescription of statins including high-intensity statins increased over time, use of high-intensity statins at discharge remained less than 25% during any time period. Utilization of revascularization within 90 days of CLI increased over time with surgical revascularization being the preferred approach during each time period. An increase in revascularization was accompanied by a significant reduction in amputation and mortality at 90-days. One-year mortality rate was high but decreased over time.ConclusionThe epidemiology of Veterans with CLI has changed over the past 10 years. Overall, adoption of guideline recommended treatments such as statins and revascularization has increased over time which has been accompanied by a reduction in amputation and mortality. However, opportunities to improve care for Veterans with CLI remain, which may potentially improve outcomes in this high-risk population.
Details
- Title: Subtitle
- Abstract 16369: Trends in Hospitalization, Management and Clinical Outcomes Among Veterans With Critical Limb Ischemia
- Creators
- Amgad Mentias - University of IowaKimberly McCoy - Iowa City VA Medical CenterAbdul Qazi - University of IowaMary Vaughan-Sarrazin - University of IowaSaket Girotra - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.138(Suppl_1 Suppl 1), pp.A16369-A16369
- Publisher
- by the American College of Cardiology Foundation and the American Heart Association, Inc
- DOI
- 10.1161/circ.138.suppl_1.16369
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Language
- English
- Date published
- 11/06/2018
- Academic Unit
- Cardiovascular Medicine; General Internal Medicine; Internal Medicine; Health Management and Policy
- Record Identifier
- 9984363429002771
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