Aortic & peripheral vascular disease
Illness Trajectories After Revascularization in Patients With Peripheral Artery Disease: A Unified Approach to Understanding the Risk of Major Amputation and Death
Authors' conclusion
Although mortality increased with age, the study highlights patients <60 years of age were at increased risk of major amputation, particularly after nonelective revascularization.
Study context
- Population
- Patients ≥50 years undergoing lower limb revascularization for PAD in England, April 2013 to March 2020
- Participants
- 94,690 patients
- Exposure
- Nonelective vs elective lower limb revascularization
- Outcome
- Major amputation and all-cause death after revascularization (illness trajectories)
Methodological detailsMarkov illness-death model, national administrative database
- Markov illness-death model
- National administrative database
Main finding
As reported in the abstract
Major amputation · 1 and 5 years after revascularization
| Group | Amputation at 1 year | Amputation at 5 years |
|---|---|---|
| Nonelective | 15.2% (95% CI, 14.4-16.0) | 19.9% (19.0-20.8) |
| Elective | 2.7% (95% CI, 2.4-3.1) | 5.3% (4.9-5.8) |
Amputation at 1 year
Nonelective15.2% (95% CI, 14.4-16.0)
Elective2.7% (95% CI, 2.4-3.1)
Amputation at 5 years
Nonelective19.9% (19.0-20.8)
Elective5.3% (4.9-5.8)
Observational data: associations, not effects.
Further findings
| Outcome | Nonelective | Elective |
|---|---|---|
| All-cause mortality · 5 years after revascularization | 64.3% (95% CI 63.2–65.5) | 33.0% (95% CI 32.0–34.1) |
Mortality after major amputation
- Increased mortality risk if major amputation within 6 months after index revascularization
Original publication
Illness Trajectories After Revascularization in Patients With Peripheral Artery Disease: A Unified Approach to Understanding the Risk of Major Amputation and Death. Circulation. Published 22 July 2024. doi:10.
Summarised from the published abstract; every number is checked against it