In acute heart failure admissions, comorbid peripheral artery disease and critical limb ischemia were associated with higher odds of mortality (aOR 1.10 and 2.77, respectively) compared to non-PAD.
Cohort
Sí
Does the presence and severity of peripheral artery disease worsen acute care outcomes and 30-day readmission in patients hospitalized for acute heart failure?
Increasing peripheral artery disease severity in acute heart failure admissions is associated with progressively worse in-hospital outcomes, higher 30-day readmission rates, and greater resource utilization.
Estimación del efecto: aOR 1.10 (95% CI 1.03-1.18)
Peripheral artery disease (PAD) commonly coexists with acute heart failure (HF), yet the short-term prognostic implications of PAD severity during HF hospitalization are uncertain. Using nationally representative data, we queried all adult (≥18 years) index admissions with a primary diagnosis of acute HF. Cohorts were stratified into 3 groups according to PAD presence and severity using the Rutherford classification. Patients with Rutherford categories 0-3 were classified as PAD, those with categories 4-6 as critical limb ischemia (CLI), and all remaining cohorts without PAD comprised the non-PAD group. Compared with non-PAD, PAD was associated with higher adjusted odds of mortality adjusted odds ratio (aOR), 1. 10; 95% confidence interval (CI), 1. 03-1. 18, acute kidney injury (AKI) (aOR, 1. 15; 95% CI, 1. 12-1. 18), cardiogenic shock (aOR, 1. 13; 95% CI, 1. 03-1. 23), nonhome discharge (aOR, 1. 15; 95% CI, 1. 11-1. 18), all-cause 30-day readmission (aOR, 1. 21; 95% CI, 1. 18-1. 25), and HF readmission (aOR, 1. 28; 95% CI, 1. 21-1. 35), as well as modestly longer length of stay by +0. 39 days and higher hospitalization costs by +500. CLI conferred markedly higher odds of mortality (aOR, 2. 77; 95% CI, 2. 06-3. 73), cardiogenic shock (aOR, 2. 31; 95% CI, 1. 65-3. 24), AKI (aOR, 1. 41; 95% CI, 1. 21-1. 65), AKI requiring dialysis (aOR, 4. 55; 95% CI, 2. 19-9. 47), and all-cause 30-day readmission (aOR, 1. 59; 95% CI, 1. 33-1. 90), with substantially greater length of stay by +5. 07 days and hospitalization costs by +19, 700. In acute HF admissions, increasing PAD severity is linked with progressively worse in-hospital outcomes and greater resource utilization, supporting early multidisciplinary inpatient management and intensified postdischarge planning for patients with PAD, particularly CLI.
Ascandar et al. (Tue,) conducted a cohort in Acute heart failure and peripheral artery disease. Peripheral artery disease (PAD) vs. No peripheral artery disease (non-PAD) was evaluated on Mortality (aOR 1.10, 95% CI 1.03-1.18). In acute heart failure admissions, comorbid peripheral artery disease and critical limb ischemia were associated with higher odds of mortality (aOR 1.10 and 2.77, respectively) compared to non-PAD.