European journal of preventive cardiology · 2026
Categorization of Patients with Peripheral Artery Disease by Charlson Comorbidity Index.
СтатьяНазвание и аннотация: Перевод в очереди
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Meertens Max, Schmitt Volker H, Kalaja Igli, Macherey-Meyer Sascha, Derda Anselm, Brochhausen Christoph, Münzel Thomas, Lurz Philipp, Hobohm Lukas, Espinola-Klein Christine, Keller Karsten
Аннотация
BACKGROUND: Peripheral artery disease (PAD) is the third leading cause of atherosclerotic morbidity. The influence of comorbidity burden on the prognosis of PAD patients is still underestimated. The Charlson Comorbidity Index (CCI) is an established tool for evaluating patients' comorbidity burden.
METHODS: We used the German nationwide inpatient statistics including all hospitalizations of patients admitted due to PAD in Germany 2005-2022 and categorized according CCI classes (mild: CCI=1-2points, moderate: CCI=3-4points, high severity: CCI>4points).
RESULTS: Overall, 3,167,987 hospitalizations of PAD patients were included in our study. Of these, 10.3% were categorized as mild, 34.3% as moderate and 55.4% as high-severity CCI class. Comorbidity burden and particularly frequency of high-severity CCI class increased from 51.2% (2006) to 58.5% (2022).An increase in the CCI class was associated with increased likelihood of being treated endovascularly (OR 1.48, 95%CI 1.48-1.49, P<0.001) rather than surgically (OR 0.87, 95%CI 0.87-0.88, P<0.001). An increase in the CCI class was associated with an elevated risk for major adverse cardiovascular and cerebrovascular events (MACCE) (OR 9.66, 95%CI 9.45-9.88, P<0.001), amputation (OR 2.82, 95%CI 2.80-2.84, P<0.001) and in-hospital case-fatality (OR 9.87, 95%CI 9.62-10.12, P<0.001).
CONCLUSION: PAD patients' comorbidity burden increased during the observational period between 2005 and 2022 in Germany. Higher comorbidity burden mirrored by higher CCI class was associated with an approximately 10-fold increased risk for MACCE and in-hospital mortality. Physicians have to be aware for the impact of comorbidity burden and optimization of the comorbidities is an important focus to improve outcomes and prevent complications.
METHODS: We used the German nationwide inpatient statistics including all hospitalizations of patients admitted due to PAD in Germany 2005-2022 and categorized according CCI classes (mild: CCI=1-2points, moderate: CCI=3-4points, high severity: CCI>4points).
RESULTS: Overall, 3,167,987 hospitalizations of PAD patients were included in our study. Of these, 10.3% were categorized as mild, 34.3% as moderate and 55.4% as high-severity CCI class. Comorbidity burden and particularly frequency of high-severity CCI class increased from 51.2% (2006) to 58.5% (2022).An increase in the CCI class was associated with increased likelihood of being treated endovascularly (OR 1.48, 95%CI 1.48-1.49, P<0.001) rather than surgically (OR 0.87, 95%CI 0.87-0.88, P<0.001). An increase in the CCI class was associated with an elevated risk for major adverse cardiovascular and cerebrovascular events (MACCE) (OR 9.66, 95%CI 9.45-9.88, P<0.001), amputation (OR 2.82, 95%CI 2.80-2.84, P<0.001) and in-hospital case-fatality (OR 9.87, 95%CI 9.62-10.12, P<0.001).
CONCLUSION: PAD patients' comorbidity burden increased during the observational period between 2005 and 2022 in Germany. Higher comorbidity burden mirrored by higher CCI class was associated with an approximately 10-fold increased risk for MACCE and in-hospital mortality. Physicians have to be aware for the impact of comorbidity burden and optimization of the comorbidities is an important focus to improve outcomes and prevent complications.