{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:43:45Z","timestamp":1790808225213,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,2,6]],"date-time":"2018-02-06T00:00:00Z","timestamp":1517875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Treatment for lifestyle limiting claudication (LLC) that is due to infra\u2010inguinal peripheral artery disease relies on either bypass, angioplasty, and\/or stenting. Given the enthusiasm and shift toward more endovascular therapy for treatment of LLC, we sought to analyze whether octogenarians benefit from infra\u2010inguinal interventions in the same manner as their younger counterparts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified all patients admitted for elective treatment of LLC from the Nationwide Inpatient Sample from 2003 to 2012, who received open surgical or endovascular intervention for infra\u2010inguinal peripheral arterial disease. These patients were divided into two groups including those between the ages 60\u201380 years (younger cohort) and those older than 80 years (octogenarians). Primary end\u2010points included morbidity and mortality and the secondary end\u2010points were length of hospital stay (LOS) and disposition after dismissal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 59,323 discharges identified in the dataset, 34,658 (58%) were males. There were 50,323 (85%) patients in the younger cohort and 9,000 (15%) octogenarians. The mean age was 69.9\u2009\u00b1\u20095.7 years and 84.2\u2009\u00b1\u20093.0 years for the younger cohort and octogenarians, respectively. The mean Charlson comorbidity index (CCI) was higher in our younger cohort (2.1\u2009\u00b1\u20091.1, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Octogenarians mainly treated with open surgery prior to 2004 are now treated endovascularly and this trend has remained stable. The younger cohort's treatment modality has fluctuated through the study period and most recently is treated mainly with open surgery. The rate of acute kidney injury, exacerbation of congestive heart failure and mortality was higher in octogenarians (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The rate of infectious wound complications was higher in the younger cohort (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Octogenarians have longer LOS and are dismissed in higher percentage to a skilled nursing facility (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). On binary logistic regression analysis, age over 80 years, female sex, higher CCI and having an open as opposed to an endovascular procedure are independent predictors of in\u2010hospital mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although endovascular techniques seem to dominate the care for octogenarians with LLC, the overall morbidity and mortality rates are significantly higher in this patient population. Other options such as medical management and\/or supervised exercise therapy should be explored in this patient group.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.27523","type":"journal-article","created":{"date-parts":[[2018,2,6]],"date-time":"2018-02-06T09:13:38Z","timestamp":1517908418000},"page":"1331-1338","source":"Crossref","is-referenced-by-count":5,"title":["Increased mortality in octogenarians treated for lifestyle limiting claudication"],"prefix":"10.1002","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1571-6955","authenticated-orcid":false,"given":"Young","family":"Erben","sequence":"first","affiliation":[{"name":"Section of Vascular and Endovascular Surgery, Department of Surgery Yale University School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos I.","family":"Mena\u2010Hurtado","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine Yale University School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel M.","family":"Miller","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School at Brown University Providence Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond A.","family":"Jean","sequence":"additional","affiliation":[{"name":"Department of Surgery Yale University School of Medicine New Haven Connecticut"},{"name":"National Clinician Scholars Program, Department of Internal Medicine Yale School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon J.","family":"Sumpio","sequence":"additional","affiliation":[{"name":"Department of Surgery Yale University School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilo A.","family":"Velasquez","sequence":"additional","affiliation":[{"name":"CES University School of Medicine Medellin Antioquia Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Mojibian","sequence":"additional","affiliation":[{"name":"Section of Vascular Interventional Radiology, Department of Radiology Yale University School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Aruny","sequence":"additional","affiliation":[{"name":"Section of Vascular Interventional Radiology, Department of Radiology Yale University School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Dardik","sequence":"additional","affiliation":[{"name":"Section of Vascular and Endovascular Surgery, Department of Surgery Yale University School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bauer E.","family":"Sumpio","sequence":"additional","affiliation":[{"name":"Section of Vascular and Endovascular Surgery, Department of Surgery Yale University School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,6]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"OrtmanJMVV HoganH.An aging nation: The older population in the United States. Population estimates and projections.https:\/\/wwwcensusgov\/prod\/2014pubs\/p25-1140pdf;2014."},{"key":"e_1_2_7_3_1","first-page":"S1","article-title":"Management of peripheral arterial disease (PAD). TASC Working Group. TransAtlantic Inter\u2010Society Consensus (TASC)","volume":"31","author":"Dormandy JA","year":"2000","journal-title":"J Vasc Surg"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2001.112210"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.12.009"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7656"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1067\/j.cpsurg.2014.02.005"},{"key":"e_1_2_7_8_1","unstructured":"Overview of the Nationwide Inpatient Sampe (NIS). HCUP Databases. Healthcare Cost and Utilization Project (HCUP). December2013. Agency for Healthcare Research and Quality R MD.www.hcup-us.ahrq.gov\/nisoverview.jsp."},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.07.114"},{"key":"e_1_2_7_10_1","unstructured":"H.OJVH.An aging nation: The older population in the Unites States. Population estimates and projections.https:\/\/wwwcensusgov\/prod\/2014pubs\/p25-1140.pdf;2014."},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwi217"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-5-201309030-00007"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00772-016-0202-2"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.12.008"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1583\/06-1843.1"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1526602816634028"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.016900"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addr.2017.05.015"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31920-1"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-017-1844-4"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-011-1237-x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.01.025"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.013440"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2015.16.4.696"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.10.114"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.10.065"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X17701592"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1536\/ihj.16-083"},{"key":"e_1_2_7_29_1","first-page":"305","article-title":"Supervised exercise therapy: It does work, but how to set up a program?","volume":"58","author":"Hageman D","year":"2017","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-015-0643-3"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.02.040"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.05.077"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.01.008"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.12.001"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1024\/0301-1526\/a000634"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.062"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-014-2785-7"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.07.028"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fccd.27523","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.27523","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T21:01:45Z","timestamp":1695502905000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.27523"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,6]]},"references-count":37,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1002\/ccd.27523"],"URL":"https:\/\/doi.org\/10.1002\/ccd.27523","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,6]]}}}