PMID- 37806215
OWN - NLM
STAT- MEDLINE
DCOM- 20231127
LR  - 20240420
IS  - 1095-8673 (Electronic)
IS  - 0022-4804 (Print)
IS  - 0022-4804 (Linking)
VI  - 293
DP  - 2024 Jan
TI  - Treatment Location Variation for Chronic Limb-Threatening Ischemia in Patients 
      With Kidney Failure.
PG  - 300-306
LID - S0022-4804(23)00408-0 [pii]
LID - 10.1016/j.jss.2023.09.009 [doi]
AB  - INTRODUCTION: End-stage kidney disease (ESKD) is an established risk factor for 
      chronic limb-threatening ischemia (CLTI). Procedural location for ESKD patients 
      has not been well described. This study aims to examine variation in index 
      procedural location in ESKD versus non-ESKD patients undergoing peripheral 
      vascular intervention for CLTI and identify preoperative risk factors for tibial 
      interventions. METHODS: Chronic limb-threatening ischemia (CLTI) patients were 
      identified in the Vascular Quality Initiative (VQI) peripheral vascular 
      intervention dataset. Patient demographics and comorbidities were compared 
      between patients with and without ESKD and those undergoing index tibial versus 
      nontibial interventions. A multivariable logistic regression evaluating risk 
      factors for tibial intervention was conducted. RESULTS: A total of 23,480 
      procedures were performed on CLTI patients with 13.6% (n = 3154) with ESKD. 
      End-stage kidney disease (ESKD) patients were younger (66.56 +/- 11.68 versus 
      71.66 +/- 12.09 y old, P = 0.019), more often Black (40.6 versus 18.6%, P < 0.001), 
      male (61.2 versus 56.5%, P < 0.001), and diabetic (81.8 versus 60.0%, P < 0.001) 
      than non-ESKD patients. Patients undergoing index tibial interventions had higher 
      rates of ESKD (19.4 versus 10.6%, P < 0.001) and diabetes (73.4 versus 57.5%, 
      P < 0.001) and lower rates of smoking (49.9 versus 73.0%, P < 0.001) than 
      patients with nontibial interventions. ESKD (odds ratio (OR) 1.67, 95% confidence 
      interval (CI) 1.52-1.86, P < 0.001), Black race (OR 1.19, 95% CI 1.09-1.30, 
      P < 0.001), and diabetes (OR 1.82, 95% CI 1.71-2.00, P < 0.001) were risk factors 
      for tibial intervention. CONCLUSIONS: Patients with ESKD and CLTI have higher 
      rates of diabetes and tibial disease and lower rates of smoking than non-ESKD 
      patients. Tibial disease was associated with ESKD, diabetes, and Black race.
CI  - Published by Elsevier Inc.
FAU - Rakestraw, Stephanie L
AU  - Rakestraw SL
AD  - Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
FAU - Novak, Zdenek
AU  - Novak Z
AD  - Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
FAU - Wang, Michael
AU  - Wang M
AD  - Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
FAU - Banks, Charles A
AU  - Banks CA
AD  - Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
FAU - Spangler, Emily L
AU  - Spangler EL
AD  - Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
FAU - Levitan, Emily B
AU  - Levitan EB
AD  - Department of Epidemiology, University of Alabama at Birmingham, Birmingham, 
      Alabama.
FAU - Locke, Jayme E
AU  - Locke JE
AD  - Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
FAU - Beck, Adam W
AU  - Beck AW
AD  - Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
FAU - Sutzko, Danielle C
AU  - Sutzko DC
AD  - Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama. 
      Electronic address: dsutzko@uabmc.edu.
LA  - eng
GR  - P30 DK079626/DK/NIDDK NIH HHS/United States
GR  - TL1 DK139566/DK/NIDDK NIH HHS/United States
GR  - U2C DK133422/DK/NIDDK NIH HHS/United States
GR  - T35 DK116670/DK/NIDDK NIH HHS/United States
GR  - T32 DK007545/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20231006
PL  - United States
TA  - J Surg Res
JT  - The Journal of surgical research
JID - 0376340
SB  - IM
MH  - Humans
MH  - Male
MH  - Chronic Limb-Threatening Ischemia
MH  - *Endovascular Procedures/methods
MH  - *Peripheral Arterial Disease/complications/epidemiology/surgery
MH  - Treatment Outcome
MH  - Ischemia/epidemiology/etiology/surgery
MH  - Risk Factors
MH  - *Diabetes Mellitus/etiology
MH  - Limb Salvage/methods
MH  - *Kidney Failure, Chronic/epidemiology/etiology/therapy
MH  - *Renal Insufficiency/etiology
MH  - Retrospective Studies
MH  - Chronic Disease
PMC - PMC10799673
MID - NIHMS1950424
OTO - NOTNLM
OT  - Chronic limbthreatening ischemia
OT  - Kidney failure
OT  - Peripheral arterial disease
EDAT- 2023/10/09 00:41
MHDA- 2023/11/27 12:44
PMCR- 2025/01/01
CRDT- 2023/10/08 18:17
PHST- 2023/03/01 00:00 [received]
PHST- 2023/08/13 00:00 [revised]
PHST- 2023/09/04 00:00 [accepted]
PHST- 2025/01/01 00:00 [pmc-release]
PHST- 2023/11/27 12:44 [medline]
PHST- 2023/10/09 00:41 [pubmed]
PHST- 2023/10/08 18:17 [entrez]
AID - S0022-4804(23)00408-0 [pii]
AID - 10.1016/j.jss.2023.09.009 [doi]
PST - ppublish
SO  - J Surg Res. 2024 Jan;293:300-306. doi: 10.1016/j.jss.2023.09.009. Epub 2023 Oct 
      6.