The relationship between medical expenses and the severity of peripheral arterial disease in Japan
The relationship between medical expenses and the severity of peripheral arterial disease in Japan
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DOI：
10.1007/s00380-018-1127-3
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发表时间：
2018-08-01
影响因子：
1.5
通讯作者：
Hoshina，Katsuyuki
中科院分区：
文献类型：
--
作者：
Seo，Akihiko;Yamamoto，Kota;Hoshina，Katsuyuki
主要目的是检查外周动脉疾病（PAD）的严重程度是否影响接受腹股沟韧带下旁路手术治疗PAD的患者的费用和住院时间。本研究纳入了80例在2012年1月至2014年12月期间因PAD接受腹股沟下旁路手术的连续患者。根据严重肢体缺血（CLI）症状和伤口、缺血和足部感染（WIfI）分类将患者分组。作为终点，我们评估了术后住院时间和住院期间的费用。CLI是延长住院时间和增加医疗费用的重要因素（p= 0.009和p = 0.001）。在CLI患者中，导致住院时间延长和医疗费用增加的显著因素是（1）远端旁路病史（分别为p= 0.33和p = 0.003）和WIfI分级中4级局部下肢状态（p= 0.0007和p = 0.053）。PAD严重程度与术后住院时间延长和医疗费用增加相关。根据WIfI分类，CLI的存在或不存在及其严重程度与轻度和重度组之间的医疗费用和住院时间相关。
The main objective is to examine whether the severity of peripheral arterial disease (PAD) affects the expenses and hospital stay of the patients who undergo bypass surgery below the inguinal ligament for PAD. Eighty consecutive patients who underwent infrainguinal bypass surgery for PAD between January 2012 and December 2014 were included in the study. Patients were divided into groups according to their critical limb ischemia (CLI) symptoms and the Wound, Ischemia, and Foot Infection (WIfI) classification. As endpoints, we assessed the duration of postoperative hospital stay and expenses during hospitalization. CLI was a significant factor for longer hospital stay and increased medical expenses (p= 0.009 andp= 0.001). In the patients with CLI, significant factors for longer hospital stay and increased medical expenses were (1) history of distal bypass (p= 0.33 andp= 0.003, respectively) and stage 4 local lower limb status in WIfI classification (p= 0.0007 andp= 0.053). PAD severity was associated with prolonged postoperative hospital stay and increased medical expenses. The presence or absence of CLI and its severity according to the WIfI classification correlated with medical expenses and hospital stay duration between the milder and severe groups.