Long-term outcome of lower extremity bypass surgery in diabetic and non-diabetic patients with critical limb-threatening ischaemia in Germany

• Verfasst von: Surmann, Johanna [VerfasserIn]
• Verfasst von: Meyer, Philipp [VerfasserIn]
• Verfasst von: Epple, Jasmin [VerfasserIn]
• Verfasst von: Schmitz-Rixen, Thomas [VerfasserIn]
• Verfasst von: Böckler, Dittmar [VerfasserIn]
• Verfasst von: Grundmann, Reinhart T. [VerfasserIn]
• Titel: Long-term outcome of lower extremity bypass surgery in diabetic and non-diabetic patients with critical limb-threatening ischaemia in Germany
• Verf.angabe: Johanna Surmann, Philipp Meyer, Jasmin Epple, Thomas Schmitz-Rixen, Dittmar Böckler and Reinhart T. Grundmann on behalf of the DIGG
• Jahr: 2024
• Umfang: 10 S.
• Illustrationen: Diagramme
• Fussnoten: Gesehen am 04.11.2024 ; Erstveröffentlichtung online: 22. Dezember 2023
• Titel Quelle: Enthalten in: Biomedicines
• Ort Quelle: Basel : MDPI, 2013
• Jahr Quelle: 2024
• Band/Heft Quelle: 12(2024), 1, Artikel-ID 38, Seite 1-10
• ISSN Quelle: 2227-9059
• DOI: doi:10.3390/biomedicines12010038
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: bypass surgery
• Sach-SW: critical limb-threatening ischaemia
• Sach-SW: diabetes
• Sach-SW: long-term survival
• Sach-SW: major amputation
• Sach-SW: open revascularisation
• Sach-SW: peripheral artery disease
• K10plus-PPN: 1907495401

Abstract

Aim: To present the short- and long-term outcomes of lower extremity bypass (LEB) surgery in patients with critical limb-threatening ischaemia (CLTI), comparing diabetic (DM) and non-diabetic (non-DM) patients. Methods: Retrospective analysis of anonymised data from a nationwide health insurance company (AOK). Data from 22,633 patients (DM: n = 7266; non-DM: n = 15,367; men: n = 14,523; women: n = 8110; mean patient age: 72.5 years), who underwent LEB from 2010 to 2015, were analysed. The cut-off date for follow-up was December 31, 2018 (mean follow-up period: 55 months). Results: Perioperative mortality was 10.0% for DM and 8.2% for non-DM (p < 0.001). Patients with crural/pedal bypasses (n = 8558) had a significantly higher perioperative mortality (10.3%) than those with above-the-knee (n = 7246; 5.8%; p < 0.001) and below-the-knee bypasses (n = 6829; 8.9%; p = 0.003). The 9-year survival rates in DM patients were significantly worse, at 21.5%, compared to non-DM, at 31.1% (p < 0.001). This applied to both PAD stage III (DM: 34.4%; non-DM: 45.7%; p < 0.001) and PAD stage IV (DM: 18.5%; non-DM: 25.0%; p < 0.001). Patients with crural/pedal bypasses had a significantly inferior survival rate (25.5%) compared to those with below-the-knee (27.7%; p < 0.001) and above-the-knee bypasses (31.7%; p < 0.001). Conclusion: Perioperative and long-term outcomes regarding survival and major amputation rate for CLTI patients undergoing LEB are consistently worse for DM patients compared to non-DM patients.