Analysis of 17 years of surgical treatment for chronic limb ischemia in a Chinese National Clinical Center for Geriatric Disorders (2002 to 2018).

Objective: The purpose of this study was to determine the trends in patient numbers, procedures numbers, amputation rate, length of stay (LOS) and hospitalization expenses in a National Clinical Research Center for Geriatric Disorders over 17 years (2002-2018).
Methods: The data of inpatients with chronic lower extremity ischemia caused by atherosclerosis in Xuanwu Hospital from 2002 to 2018 was reviewed.
Results: 5137 patients were reviewed, of whom 58% (2976/5137) were diabetic. The numbers of annual inpatients, endovascular treatment cases, and mean hospitalization expenses increased over time, and the mean LOS progressively decreased. The amputation rate decreased from 8.12% in 2002 to 2007 to 0.87% in 2008 to 2018 (P < .0001). The mean LOS decreased from 28.20 days in 2002 to 2007 to 11.12 days in 2008 to 2018 (P < .0001). The mean hospitalization expenses rose from 54,466.94 yuan in 2002 to 2007 to 76,469.40 yuan in 2008-2018 (p = .0013). There were no significant differences in mean LOS and mean hospitalization expenses between the diabetic and the non-diabetic groups. In the diabetic subgroup, the amputation rate decreased from 8.83% in 2002 to 2007 into 0.99% in 2008 to 2018 (P < .0001).
Conclusion: From 2002 to 2018, the number of inpatients with atherosclerotic chronic lower limb ischemia increased gradually, and the number of endovascular treatments increased significantly; concomitantly, the amputation rate and mean LOS decreased, and the mean hospitalization expenses increased. The decreased amputation rate may be related to increased implementation of endovascular treatment or angiogenesis therapy.
Competing Interests: Declaration of Competing Interest There were no conflicts of interest.
(Copyright © 2020. Published by Elsevier B.V.)