PMID- 36115521
OWN - NLM
STAT- MEDLINE
DCOM- 20230124
LR  - 20230201
IS  - 1097-6809 (Electronic)
IS  - 0741-5214 (Linking)
VI  - 77
IP  - 2
DP  - 2023 Feb
TI  - Association of depression and anxiety disorders with outcomes after 
      revascularization in chronic limb-threatening ischemia hospitalizations 
      nationwide.
PG  - 480-489
LID - S0741-5214(22)02246-7 [pii]
LID - 10.1016/j.jvs.2022.09.008 [doi]
AB  - OBJECTIVE: Patients with chronic limb-threatening ischemia (CLTI), the end stage 
      of peripheral artery disease, often present with comorbid depression and anxiety 
      disorders. The prevalence of these comorbidities in the inpatient context over 
      time, and their association with outcomes after revascularization and resource 
      usage is unknown. METHODS: Using the 2011 to 2017 National Inpatient Sample, two 
      cohorts were created-CLTI hospitalizations with endovascular revascularization 
      and CLTI hospitalizations with surgical revascularization. Within each cohort, 
      the annual prevalence of depression and anxiety disorder diagnoses was 
      determined, and temporal trends were evaluated using the Cochran-Mantel-Haenszel 
      test. Hierarchical multivariable logistic and linear regression analyses were 
      used to examine the association of depression and anxiety disorder diagnoses with 
      inpatient major amputation, mortality, length of stay (LOS), and cost, adjusting 
      for illness severity, comorbidities, and potential bias in the documentation of 
      depression and anxiety disorder diagnoses stratified by patient sociodemographic 
      data. RESULTS: Across the study period were a total of 245,507 CLTI-related 
      hospitalizations with endovascular revascularization and 138,922 with surgical 
      revascularization. Hospitalizations with a depression or anxiety disorder 
      diagnosis increased from 10.8% in 2011 to 15.3% in 2017 in the endovascular 
      revascularization cohort and from 11.7% in 2011 to 14.4% in 2017 in the surgical 
      revascularization cohort (P(trend) < .001). In the endovascular revascularization 
      cohort, depression was associated with higher odds of major amputation (odds 
      ratio, 1.15; 95% confidence interval, 1.03-1.30). In addition, depression (9 vs 
      8 days [P < .001]; $105,754 vs $102,481 [P = .018]) and anxiety disorder (9 vs 
      8 days [P < .001]; $109,496 vs $102,324 [P < .001]) diagnoses were associated 
      with a longer median LOS and higher median costs. In the surgical 
      revascularization cohort, depression was associated with a higher odds of major 
      amputation (odds ratio, 1.33; 95% confidence interval, 1.13-1.58) and a longer 
      LOS (median, 9 vs 9 days; P = .004). CONCLUSIONS: Depression and anxiety disorder 
      diagnoses have become increasingly prevalent among CLTI hospitalizations 
      including revascularizations. When present, these psychiatric comorbidities are 
      associated with an increased risk of amputation and greater resource usage.
CI  - Copyright (c) 2022 Society for Vascular Surgery. Published by Elsevier Inc. All 
      rights reserved.
FAU - Harris, Kristie M
AU  - Harris KM
AD  - Vascular Medicine Outcomes Program, Section of Cardiovascular Medicine, 
      Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
FAU - Mena-Hurtado, Carlos
AU  - Mena-Hurtado C
AD  - Vascular Medicine Outcomes Program, Section of Cardiovascular Medicine, 
      Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
FAU - Burg, Matthew M
AU  - Burg MM
AD  - Vascular Medicine Outcomes Program, Section of Cardiovascular Medicine, 
      Department of Internal Medicine, Yale School of Medicine, New Haven, CT; 
      Department of Cardiology, Veterans Affairs Connecticut Healthcare System, West 
      Haven, CT.
FAU - Vriens, Patrick W
AU  - Vriens PW
AD  - Department of Surgery, Elisabeth Tweesteden Hospital, Tilburg, The Netherlands; 
      Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The 
      Netherlands.
FAU - Heyligers, Jan
AU  - Heyligers J
AD  - Department of Surgery, Elisabeth Tweesteden Hospital, Tilburg, The Netherlands.
FAU - Smolderen, Kim G
AU  - Smolderen KG
AD  - Vascular Medicine Outcomes Program, Section of Cardiovascular Medicine, 
      Department of Internal Medicine, Yale School of Medicine, New Haven, CT; 
      Department of Psychiatry, Yale School of Medicine, New Haven, CT. Electronic 
      address: kim.smolderen@yale.edu.
LA  - eng
PT  - Journal Article
DEP - 20220915
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
SB  - IM
MH  - Humans
MH  - Chronic Limb-Threatening Ischemia
MH  - Risk Factors
MH  - Depression/diagnosis/epidemiology
MH  - Limb Salvage
MH  - Hospitalization
MH  - *Peripheral Arterial Disease/diagnosis/epidemiology/surgery
MH  - Retrospective Studies
MH  - Ischemia/diagnosis/epidemiology/surgery
MH  - Treatment Outcome
MH  - Chronic Disease
MH  - *Endovascular Procedures/adverse effects
OTO - NOTNLM
OT  - Amputation
OT  - Anxiety
OT  - Chronic limb-threatening ischemia
OT  - Depression
OT  - Peripheral artery disease
OT  - Revascularization
EDAT- 2022/09/18 06:00
MHDA- 2023/01/25 06:00
CRDT- 2022/09/17 19:25
PHST- 2022/07/07 00:00 [received]
PHST- 2022/09/01 00:00 [revised]
PHST- 2022/09/03 00:00 [accepted]
PHST- 2022/09/18 06:00 [pubmed]
PHST- 2023/01/25 06:00 [medline]
PHST- 2022/09/17 19:25 [entrez]
AID - S0741-5214(22)02246-7 [pii]
AID - 10.1016/j.jvs.2022.09.008 [doi]
PST - ppublish
SO  - J Vasc Surg. 2023 Feb;77(2):480-489. doi: 10.1016/j.jvs.2022.09.008. Epub 2022 
      Sep 15.