■闭塞性下肢动脉疾病(LEAD)的患病率正在全球范围内上升,而欧洲流行病学数据却很少。我们报告了1996年至2018年丹麦LEAD修复的发病率和死亡率,对开放主动脉-髂动脉分层,开放外围,和血管内修复。
■一项涵盖1996年至2018年的丹麦人口登记册前瞻性数据的全国性队列研究。合并症采用Charlson的合并症指数(CCI)进行评估。通过多变量泊松和Cox回归估计发病率(IR)和死亡率(MRR),分别。
■我们确定了41,438名独特的患者正在接受46,236例首次通过主动脉-liac进行LEAD修复(n=5213),外周手术(n=18,665)或经皮经腔血管成形术(PTA,n=22,358)。从1996年到2018年,初级血运重建的年龄和性别标准化IR从每100,000人年71.8降至50.2(IRR,0.70;95%CI,0.66-0.75)。从1996年到2010年,PTA的IR增加了2.5倍,所有三种修复技术在2010年后均呈下降趋势。IR下降是由于跛行导致的LEAD修复减少所致,以及80岁以下的人,而80岁以上人群的IR增加(p交互作用<0.001)。男性铅修复更频繁(IRR女性vs男性,0.78;95%CI,0.77-0.80),这在日历时间上是一致的(p相互作用=0.41)。开放/手术修复后,粗死亡率下降,并在PTA之后增加,但与研究期的开始和结束相比,这三种技术的调整后死亡率都有降低的趋势(MRRaorto,0.71;95%CI,0.54-0.93vsMRR外围设备,0.76;95%CI,0.69-0.83vsMRRPTA,0.96;95%CI,0.86-1.07)。年龄增长和CCI,男性,吸烟,和与死亡率增加相关的护理依赖。
■从1996年到2018年,丹麦的LEAD修复发生率下降,尤其是在80岁以下的人群中,主要是由于跛行的血运重建减少。开放手术后调整后的死亡率下降,但在PTA之后似乎没有改变。
UNASSIGNED: The prevalence of occlusive lower extremity artery disease (LEAD) is rising worldwide while European epidemiology data are scarce. We report incidence and mortality of LEAD repair in Denmark from 1996 through 2018, stratified on open aorto-iliac, open peripheral, and endovascular repair.
UNASSIGNED: A nationwide cohort
study of prospective data from population-based Danish registers covering 1996 to 2018. Comorbidity was assessed by Charlson\'s Comorbidity Index (CCI). Incidence rate (IR) ratios and mortality rate ratios (MRR) were estimated by multivariable Poisson and Cox regression, respectively.
UNASSIGNED: We identified 41,438 unique patients undergoing 46,236 incident first-time LEAD repairs by either aorto-iliac- (n=5213), peripheral surgery (n=18,665) or percutaneous transluminal angioplasty (PTA, n=22,358). From 1996 to 2018, the age- and sex-standardized IR for primary revascularization declined from 71.8 to 50.2 per 100,000 person-years (IRR, 0.70; 95% CI, 0.66-0.75). Following a 2.5-fold IR increase of PTA from 1996 to 2010, all three repair techniques showed a declining trend after 2010. The declining IR was driven by decreasing LEAD repair due to claudication, and by persons aged below 80 years, while the IR increased in persons aged above 80 years (p interaction<0.001). LEAD repair was more frequent in men (IRRfemale vs male, 0.78; 95% CI, 0.77-0.80), which was consistent over calendar time (p interaction=0.41). Crude mortality decreased following open/surgical repair, and increased following PTA, but all three techniques trended towards lower adjusted mortality comparing the start and the end of the
study period (MRRaorto-iliac, 0.71; 95% CI, 0.54-0.93 vs MRRperipheral, 0.76; 95% CI, 0.69-0.83 vs MRRPTA, 0.96; 95% CI, 0.86-1.07). Increasing age and CCI, male sex, smoking, and care dependency associated with increased mortality.
UNASSIGNED: The incidence rate of LEAD repair decreased in Denmark from 1996 to 2018, especially in persons younger than 80 years, and primarily due to reduced revascularization for claudication. Adjusted mortality rates decreased following open surgery, but seemed unaltered following PTA.