Date of Award

1-1-2022

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Carlos Mena-Hurtado

Abstract

ABSTRACTBackground: Previous studies on select populations have shown worsened limb outcomes among patients with comorbid Peripheral artery disease (PAD) and Microvascular disease (MVD), however this connection has not been studied in larger populations. Using a national database, we aimed to analyze the frequency of Major Adverse Limb Events (MALE), as well as Major Adverse Cardiac Events (MACE), Mortality, and other comorbidities for patients with comorbid PAD/MVD, as compared to patients with PAD or MVD alone. Methods: Using 2011 to 2018 National Readmission Database (NRD) data, we identified the frequency of PAD and MVD-related admissions based on ICD-9/10 codes. The primary outcomes of interest were MALE, MACE, and mortality, while secondary outcomes were length of stay and hospitalization cost. Patient socio-demographic characteristics, including age, gender, insurance and household income; and comorbidities were compared by disease group using standardized differences, with values of d≥0.20 equivalent to a small effect size or larger highlighted. Outcomes were stratified by disease status (PAD-only, MVD-only, and comorbid PAD+MVD), with MVD-only patients serving as the reference group. Results: There were 21,270,666 MVD-only, 9,133,256 PAD-only, and 3,568,847 comorbid PAD/MVD-related hospitalizations from 2011 to 2018. There were no significant differences in age or sex between all three groups (d

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