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Diabetes Mellitus and its impact on patient-profile and in-hospital outcomes in peripheral artery disease

Background: In patients with peripheral artery disease (PAD), the impact of diabetes mellitus (DM) on patient-profile and adverse in-hospital events is not well investigated. Methods: The German nationwide inpatient sample 2005-2019 was used for this analysis. Hospitalized PAD patients were stratifi...

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Main Authors: Keller, Karsten (Author) , Schmitt, Volker H. (Author) , Vosseler, Markus (Author) , Brochhausen, Christoph (Author) , Münzel, Thomas (Author) , Hobohm, Lukas (Author) , Espinola-Klein, Christine (Author)
Format: Article (Journal)
Language:English
Published: 28 October 2021
In: Journal of Clinical Medicine
Year: 2021, Volume: 10, Issue: 21, Pages: 1-13
ISSN:2077-0383
DOI:10.3390/jcm10215033
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/jcm10215033
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2077-0383/10/21/5033
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Author Notes:Karsten Keller, Volker H. Schmitt, Markus Vosseler, Christoph Brochhausen, Thomas Münzel, Lukas Hobohm and Christine Espinola-Klein
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Summary:Background: In patients with peripheral artery disease (PAD), the impact of diabetes mellitus (DM) on patient-profile and adverse in-hospital events is not well investigated. Methods: The German nationwide inpatient sample 2005-2019 was used for this analysis. Hospitalized PAD patients were stratified for DM and the influence of DM on patient-profile and adverse in-hospital events was investigated. Results: Our study comprised 2,654,871 hospitalizations (54.3% aged ≥70 years, 36.7% females) of patients with PAD in Germany 2005-2019. Among these, 864,691 (32.6%) patients had DM and 76,716 (2.9%) died during hospitalization. Diabetic PAD patients revealed an aggravated cardiovascular profile (Charlson Comorbidity Index: 6.0 (5.0-8.0) vs. 4.0 (3.0-5.0), p < 0.001). PAD patients with DM showed a higher rate of in-hospital mortality (3.5% vs. 2.6%, p < 0.001), as well as major adverse cardiovascular and cerebrovascular events (MACCE, 4.7% vs. 3.3%, p < 0.001) and had more often operated with amputation surgery (16.4% vs. 9.1%, p < 0.001). DM was an independent predictor of in-hospital mortality (OR 1.077 (95%CI 1.060-1.093), p < 0.001) and MACCE (OR 1.118 (95%CI 1.103-1.133), p < 0.001). In addition, amputations were also associated with DM (OR 1.804 (95%CI 1.790-1.818)), p < 0.001). Conclusions: DM is associated with an unfavorable clinical patient-profile and higher risk for adverse events in PAD patients, including substantially increased in-hospital mortality as well as MACCE rate, and were more often associated with amputation surgeries.
Item Description:Gesehen am 05.01.2022
Physical Description:Online Resource
ISSN:2077-0383
DOI:10.3390/jcm10215033

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