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.