Study: Hospitalizations for Severe Peripheral Artery Disease are Highest and Rising Fastest Among Young, Low-Income Men

February 3, 2022 — Nearly half of all critical limb ischemia-related hospitalizations in the U.S. occur among adults under the age of 65, a Yale-led study has found.

The authors collected inpatient data from the 2011 to 2017 National Inpatient Sample to evaluate the impact of race, sex, and lifestyle on hospital admission rates. Between 2011-2017, the number of CLI-related hospitalizations in the U.S. rose from 326,228 to 494,225. Among adults younger than 65, the findings showed a sharp increase from 129,566 to 243,435 — nearly 50 percent of all hospitalizations in 2017.

In 2017, 33 percent of hospitalizations were men under the age of 65 years, compared with 26 percent in 2011. Critical limb ischemia (CLI) is caused by restricted blood flow peripheral arterial vessels. Patients with multiple comorbidities may require limb amputation.

The authors discovered that smoking, obesity, and diabetes contributed to the growing number of emergency hospitalizations among young adults. Minorities, low-income adults, and individuals who suffer from mental health disorders were also more likely to be hospitalized.

“Further research is also needed to determine the effect of the influx of younger adults hospitalized with CLI on the larger health care system, including provider burnout and compassion fatigue, and quality of care metrics, such as hospital readmission rates, procedural complication rates, and health care costs.”

The authors added that a holistic approach was key to prevent further complications and improve the quality of vascular care.

“The combination of comorbidities seen in younger patients with CLI suggests that behavioral medicine should be included in multispecialty integrated vascular care, and that a population health approach should be used to design preventative measures that mitigate the devastating impacts of CLI and associated comorbidities,” they said.

The study was published in the Journal of the American College of Cardiology.

Yale authors included Kristie M. Harris, PhD, Carlos Mena-Hurtado, MD, Kim G. Smolderen, PhD, Ahmad Arham, MD, Rajita Sinha, PhD, and Matthew M. Burg, PhD. Co-authors included Kenneth E. Freedland, PhD of Washington University School of Medicine, and Olamide Alabi, MD, of Emory University School of Medicine.