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Cardiovascular Intervention and Therapeutics

30-04-2024 | Original Article

Analysis of in-hospital deaths in patients with critical limb ischemia necessitating invasive treatments: based on a Japanese nationwide database

Authors: Kiwamu Iwata, Manabu Nitta, Makoto Kaneko, Kiyohide Fushimi, Shinichiro Ueda, Sayuri Shimizu

Published in: Cardiovascular Intervention and Therapeutics

Abstract

Critical limb ischemia (CLI) is associated with systemic cardiovascular and non-cardiovascular diseases. Treatments primarily targeting limb-related outcomes may not improve overall life prognosis. We aimed to describe in-hospital mortality and the underlying etiologies in Japanese patients with CLI. We analyzed the Diagnosis Procedure Combination (DPC) database from approximately 1200 Japanese acute-care hospitals between April 2018 and March 2020. The definition of patients with CLI was based on the diagnostic codes listed as the most resource-intensive diagnosis and information regarding invasive procedures (endovascular treatment, bypass, or amputation). The DPC database provides information on whether in-hospital death was caused by the most resource-intensive diagnosis. Among 15,228 distinct patients with CLI, we identified 18,970 records, including 5,378 amputations. In-hospital death occurred in 1238 (6.5%) patients. Among them, 811 (65.5%) were due to causes unrelated to CLI. In patients who underwent amputation (n = 5378), causes unrelated to CLI accounted for 70.0% of in-hospital deaths, whereas among patients who did not undergo amputation (n = 13,592), this proportion was 60.1%. When compared to patients who died due to causes related to CLI, the prevalence of male patients was higher (62.6% vs 52.7%, p = 0.001), and amputation was more frequently performed (58.0% vs 47.1%, p < 0.001) in those who died due to causes unrelated to CLI. The majority of in-hospital deaths among patients with CLI necessitating endovascular treatment, bypass, or amputation were attributable to factors unrelated to the primary condition of CLI. Managing systemic cardiovascular and non-cardiovascular diseases beyond the affected limb is crucial to improve the prognosis of these patients.

Graphical Abstract

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Title: Analysis of in-hospital deaths in patients with critical limb ischemia necessitating invasive treatments: based on a Japanese nationwide database
Authors: Kiwamu Iwata
Manabu Nitta
Makoto Kaneko
Kiyohide Fushimi
Shinichiro Ueda
Sayuri Shimizu
Publication date: 30-04-2024
Publisher: Springer Nature Singapore
Published in: Cardiovascular Intervention and Therapeutics
Print ISSN: 1868-4300
Electronic ISSN: 1868-4297
DOI: https://doi.org/10.1007/s12928-024-01003-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Analysis of in-hospital deaths in patients with critical limb ischemia necessitating invasive treatments: based on a Japanese nationwide database

Abstract

Graphical Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Graphical Abstract

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