Invasively-treated incidence of lower extremity peripheral arterial disease and associated factors in Taiwan: 2000–2011 nationwide hospitalized data analysis

Abstract

BackgroundLower extremity (LE) peripheral artery disease (PAD), which is associated with a reduced quality of life and increased mortality from atherosclerotic cardio-/cerebro-vascular occlusion, is a significant public health problem, especial for an aging society such as that of Taiwan.MethodsSpecific datasets of the 2000–2011 nationwide inpatient databases were analyzed. Two inclusion criteria, including one of the major diagnosis codes of PAD and one of three categorical invasive treatments of LE PAD, were used consecutively to select cases diagnosed as LE PAD and receiving invasive treatment. The epidemiology of invasively-treated PAD in Taiwan was estimated, and the influences of potential confounders on these invasively-treated methods were evaluated.ResultsIn general, the invasively-treated incidence of PAD in Taiwan doubled, from 3.73/10,000 (in 2000) to 7.48/10,000 (in 2011). On average, the total direct medical cost of one hospitalized and invasively-treated PAD case ranged from $US 4,600 to $US 5,900. The annual cases of bypass surgery for the PAD cases averaged 1,000 and the cases for limb amputation ranged from 4,100 to 5,100 annually. However, the number of percutaneous transluminal angioplasty (PTA) procedures remarkably increased by 15 times, from 600/year to 9,100/year, from 2000 to 2011. 51.3% of all the enrolled cases were treated with limb amputations, and female, young and middle-aged people (30–65 years of age), DM patients and those on a low income had a tendency to undergo amputation due to PAD. 37.6% of all the enrolled cases were treated with PTAs related to hypertension, cardiovascular disease, hyperlipidemia and catastrophic Illness. 2-year PTA failure rates of 22.13%, 11.91% and 10.61% were noted among the first (2000–2001), second (2004–2005) and the third (2008–2009) cohort groups, respectively.ConclusionsIn Taiwan, a gender difference and age and period effects on the invasively-treated incidence of LE PAD were observed. Female, young and middle-aged people (30–50 and 50–65 years of age), DM patients and those on a low income had a tendency to undergo amputation. The number of PTA procedures remarkably increased, but the 2-year failure rate of PTAs reduced from 2000 to 2011.

Hepatitis C virus infection increases the risk of developing peripheral arterial disease: A 9-year population-based cohort study

“…According to an analysis of Medicare enrollees, 6.8% of elderly Medicare enrollees received PAD treatment [12]. From 2000 to 2011, the incidence of invasive PAD treatment in Taiwan doubled, and the number of percutaneous transluminal angioplasty procedures increased 15-fold [8]. The reported risk factors of PAD include older age, male sex, smoking, DM, HTN, hyperlipidemia (HL), CKD, albuminuria, and chronic obstructive pulmonary disease (COPD) [10,11,[13][14][15][16].…”

“…Peripheral arterial disease (PAD) is an under-diagnosed and undertreated disease [8], causing considerable burden to health care systems worldwide. Previous studies have reported that the prevalence of asymptomatic PAD ranges from 4.3% to 5.4% in the general population of Taiwan and the United States [9,10], reaching 12.2% in people older than 60 years [11].…”

The association between blood lead levels and cardiovascular diseases among lead-exposed male workers

“…Earlier epidemiological studies found that environmental exposure to lead was associated with PAD development (19,20). PAD increases the risk of mortality from cardiovascular disease (21). However, only a few patients were admitted with PAD.…”

Using Big Data to Develop the Epidemiology of Orthopedic Trauma

“…It is important for an orthopedic researcher to learn some modern biostatistics to deal with nationwide big data. For example, three basic epidemiological study designs can be applied to an existing big-data for healthcare to study orthopedic medicine: crosssectional study [4][5][6][7][8][9], retrospective case-control study [10][11][12], and retrospective cohort study [13][14][15]. Methods to estimate the prevalence or incidence of some orthopedic disorders or injuries, to evaluate their associated factors, to select other comparable groups and to use some suitable statistical models are shown in Table 1.…”

“…Based on our restricted experience, the descriptive epidemiology of orthopedic trauma could use big data such as a nationwide health insurance databank to calculate prevalences [4,6,7] or incidences [5,[8][9][10] with 95% confidence intervals (CIs), and analytic epidemiology of orthopedics could be also performed. All the enrolled cases could be divided into several subgroups for comparison [11,12,14,15], but a control group may be randomly selected from the other normal population by a matched method [13]. In a retrospective data analysis, the odds ratio (OR) with the 95% CI is evaluated [11][12][13], usually by a binominal logistic regression (LR) model or an innovative multi-level logistic regression (MLLR) model [11,12].…”