Outcome of revascularization procedures for peripheral arterial occlusive disease in Ontario between 1991 and 1998: A population-based study
Outcome of revascularization procedures for peripheral arterial occlusive disease in Ontario between 1991 and 1998: A population-based study
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DOI：
10.1016/s0741-5214(03)00274-x
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发表时间：
2003-08-01
影响因子：
4.3
通讯作者：
Kucey, DS
中科院分区：
文献类型：
--
作者：
Al-Omran, M;Tu, JV;Kucey, DS
目的：我们使用基于人群的管理数据描述了用于治疗外周动脉闭塞性疾病 (PAOD) 的血运重建手术的结果。方法。利用加拿大安大略省的行政数据库，在 1991 至 1998 财年进行了一项基于人群的回顾性队列研究，以确定接受动脉搭桥手术和经皮腔内血管成形术治疗 PAOD 的患者。采用Kaplan-Meier法计算累积生存率和无截肢生存率。为了分析影响这些比率的因素，使用 Cox 比例风险模型进行了多变量分析。结果。在研究期间，15,824 名患者接受了搭桥手术，11,548 名患者接受了血管成形术。接受搭桥手术的患者5年累积生存率为61.5%，无大截肢生存率为83.4%，而接受血管成形术的患者分别为69%和92.2%。男性、年龄较大、糖尿病和心脏病与血运重建手术后死亡风险增加相关。血运重建手术后大截肢风险增加与男性、年龄较大和糖尿病相关，而高血压与风险降低相关。 结论：为了在人群水平评估 PAOD 血运重建手术的长期结果，应使用生存率和无大截肢生存率，因为与血运重建和截肢手术使用率之间的相关性相比，它们提供了更临床可接受的估计值，后者已用于描述先前发表的文献报告中的结果。
Purpose: We describe the outcome of revascularization procedures used to treat peripheral arterial occlusive disease (PAOD), using population-based administrative data.Methods. A retrospective population-based cohort study utilizing administrative databases in Ontario, Canada, was conducted for fiscal years 1991 to 1998 to identify patients who underwent arterial bypass surgery and percutanous transluminal angioplasty to treat PAOD. The Kaplan-Meier method was used to calculate cumulative survival rate and amputation-free survival rate. To analyze factors that affect these rates, multivariate analysis was performed with Cox proportional hazard models.Results. Over the study period 15,824 patients underwent bypass operations and 11,548 underwent angioplasty. For patients who underwent bypass surgery, 5-year cumulative survival rate was 61.5% and major amputation-free survival rate was 83.4%, compared with 69% and 92.2%, respectively, for patients who underwent angioplasty. Male sex, older age, diabetes, and heart disease were associated with increased risk for death after revascularization procedures. Increased risk for major amputation after revascularization procedures was associated with male sex, older age, and diabetes, whereas hypertension was linked to decreased risk.Conclusion: To evaluate the long-term outcome of revascularization procedures for PAOD at the population level, survival and major amputation-free survival rates should be used, because they provide more clinically accepted estimates compared with the correlation between utilization rates for revascularization and amputation procedures, which have been used to describe outcome in previously published reports in the literature.