PDF(Pubmed)
Abstract：
UNASSIGNED: Chronic limb-threatening ischemia (CLTI) is a common condition with high rates of morbidity and mortality. Despite extensive literature documenting poor outcomes in patients with CLTI, as well as racial, ethnic, socioeconomic, and geographic disparities in these outcomes, process measures for high-quality CLTI care have not been developed. We developed the Chronic Limb threatening Ischemia Process PERformace (CLIPPER) cohort to develop and test the validity of CLTI care quality measures.
UNASSIGNED: Using inpatient and outpatient claims data from patients with fee-for-service Medicare from 2010 to 2019, we created a coding algorithm to identify patients with CLTI. To qualify for a CLTI diagnosis, patients had to have either diagnostic codes for peripheral artery disease and for ulceration, infection, or gangrene on the same inpatient or outpatient claim or a CLTI-specific diagnostic code. Patients were also required to have a procedural code indicating arterial vascular testing within 6 months before or after the earliest qualifying CLTI diagnostic code(s). We describe baseline characteristics and long-term outcomes of this cohort.
UNASSIGNED: The final cohort comprised 1,130,065 patients diagnosed with CLTI between 2010 and 2019. Mean (±SD) age of the cohort was 75 ± 5.8 years; 48.4% were women, and 14.6% were Black. Within 30 days of CLTI diagnosis, 20.4% of patients underwent either percutaneous or surgical revascularization. Within 6 months, 3.3% of patients underwent major amputation; 16.7% of patients died within 1 year and 50.3% within 5 years.
UNASSIGNED: We described the development of a cohort of fee-for-service Medicare patients with CLTI using inpatient and outpatient Medicare claims data. CLIPPER will be a resource for developing a set of process measures that can be captured from administrative claims data, with plans to describe their association with limb outcomes and corresponding racial, ethnic, socioeconomic, sex-based, and geographic variability.
UNASSIGNED: Using inpatient and outpatient claims data from patients with fee-for-service Medicare from 2010 to 2019, we created a coding algorithm to identify patients with CLTI. To qualify for a CLTI diagnosis, patients had to have either diagnostic codes for peripheral artery disease and for ulceration, infection, or gangrene on the same inpatient or outpatient claim or a CLTI-specific diagnostic code. Patients were also required to have a procedural code indicating arterial vascular testing within 6 months before or after the earliest qualifying CLTI diagnostic code(s). We describe baseline characteristics and long-term outcomes of this cohort.
UNASSIGNED: The final cohort comprised 1,130,065 patients diagnosed with CLTI between 2010 and 2019. Mean (±SD) age of the cohort was 75 ± 5.8 years; 48.4% were women, and 14.6% were Black. Within 30 days of CLTI diagnosis, 20.4% of patients underwent either percutaneous or surgical revascularization. Within 6 months, 3.3% of patients underwent major amputation; 16.7% of patients died within 1 year and 50.3% within 5 years.
UNASSIGNED: We described the development of a cohort of fee-for-service Medicare patients with CLTI using inpatient and outpatient Medicare claims data. CLIPPER will be a resource for developing a set of process measures that can be captured from administrative claims data, with plans to describe their association with limb outcomes and corresponding racial, ethnic, socioeconomic, sex-based, and geographic variability.
摘要：
■慢性威胁肢体缺血（CLTI）是一种常见的疾病，发病率和死亡率很高。尽管大量文献记录了CLTI患者的不良预后，以及种族，民族,社会经济,以及这些结果的地理差异，高质量CLTI护理的过程措施尚未开发。我们开发了慢性威胁肢体缺血过程性能（CLIPPER）队列，以开发和测试CLTI护理质量措施的有效性。
■使用2010年至2019年的按服务付费Medicare患者的住院和门诊索赔数据，我们创建了一种编码算法来识别CLTI患者。要获得CLTI诊断的资格,患者必须有外周动脉疾病和溃疡的诊断代码，感染,或同一住院或门诊索赔或CLTI特定诊断代码的坏疽。患者还需要在最早的合格CLTI诊断代码之前或之后的6个月内具有指示动脉血管测试的程序代码。我们描述了该队列的基线特征和长期结果。
■最终队列包括2010年至2019年诊断为CLTI的1,130,065例患者。该队列的平均（±SD）年龄为75±5.8岁；48.4％为女性，黑人占14.6%。CLTI诊断后30天内,20.4%的患者接受经皮或手术血运重建。六个月内,3.3%的患者接受了大截肢；16.7%的患者在1年内死亡，50.3%在5年内死亡。
我们使用住院和门诊医疗保险索赔数据描述了一组CLTI按服务付费医疗保险患者的发展。CLIPPER将成为开发一系列过程措施的资源，这些措施可以从行政索赔数据中捕获，计划描述他们与肢体结果和相应种族的联系，民族,社会经济,基于性别,和地理可变性。
■使用2010年至2019年的按服务付费Medicare患者的住院和门诊索赔数据，我们创建了一种编码算法来识别CLTI患者。要获得CLTI诊断的资格,患者必须有外周动脉疾病和溃疡的诊断代码，感染,或同一住院或门诊索赔或CLTI特定诊断代码的坏疽。患者还需要在最早的合格CLTI诊断代码之前或之后的6个月内具有指示动脉血管测试的程序代码。我们描述了该队列的基线特征和长期结果。
■最终队列包括2010年至2019年诊断为CLTI的1,130,065例患者。该队列的平均（±SD）年龄为75±5.8岁；48.4％为女性，黑人占14.6%。CLTI诊断后30天内,20.4%的患者接受经皮或手术血运重建。六个月内,3.3%的患者接受了大截肢；16.7%的患者在1年内死亡，50.3%在5年内死亡。
我们使用住院和门诊医疗保险索赔数据描述了一组CLTI按服务付费医疗保险患者的发展。CLIPPER将成为开发一系列过程措施的资源，这些措施可以从行政索赔数据中捕获，计划描述他们与肢体结果和相应种族的联系，民族,社会经济,基于性别,和地理可变性。
