{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:05:00Z","timestamp":1789589100829,"version":"build-2803163510"},"reference-count":44,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Peripheral artery disease (PAD) is the third leading cause of atherosclerotic morbidity. The influence of comorbidity burden on the prognosis of PAD patients is still underestimated. The Charlson Comorbidity Index (CCI) is an established tool for evaluating patients\u2019 comorbidity burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We used the German nationwide inpatient statistics including all hospitalizations of patients admitted due to PAD in Germany 2005\u201322 and categorized according to CCI classes (mild: CCI score of 1\u20132 points, moderate: CCI score of 3\u20134 points, high severity: CCI score &amp;gt; 4 points). Overall, 3 167 987 hospitalizations of PAD patients were included in our study. Of these, 10.3% were categorized as mild, 34.3% as moderate, and 55.4% as high-severity CCI class. Comorbidity burden and particularly frequency of high-severity CCI class increased from 51.2% (2006) to 58.5% (2022). An increase in the CCI class was associated with increased likelihood of being treated endovascularly [odds ratio (OR) 1.48, 95% confidence interval (CI) 1.48\u20131.49, P &amp;lt; 0.001] rather than surgically (OR 0.87, 95% CI 0.87\u20130.88, P &amp;lt; 0.001). An increase in the CCI class was associated with an elevated risk for major adverse cardiovascular and cerebrovascular events (MACCE) (OR 9.66, 95% CI 9.45\u20139.88, P &amp;lt; 0.001), amputation (OR 2.82, 95% CI 2.80\u20132.84, P &amp;lt; 0.001), and in-hospital case fatality (OR 9.87, 95% CI 9.62\u201310.12, P &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Peripheral artery disease patients\u2019 comorbidity burden increased during the observational period between 2005 and 2022 in Germany. Higher comorbidity burden mirrored by higher CCI class was associated with an approximately 10-fold increased risk for MACCE and in-hospital mortality. Physicians have to be aware of the impact of comorbidity burden and optimization of the comorbidities is an important focus to improve outcomes and prevent complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag146","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T12:31:13Z","timestamp":1772973073000},"source":"Crossref","is-referenced-by-count":3,"title":["Categorization of patients with peripheral artery disease by Charlson Comorbidity Index"],"prefix":"10.1093","author":[{"given":"Max","family":"Meertens","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Medical Centre of the Johannes Gutenberg University , Langenbeckstrasse 1, Mainz 55131 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5070-7280","authenticated-orcid":false,"given":"Volker 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55131 ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Lurz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Centre of the Johannes Gutenberg University , Langenbeckstrasse 1, Mainz 55131 ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Hobohm","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Centre of the Johannes Gutenberg University , Langenbeckstrasse 1, Mainz 55131 ,","place":["Germany"]},{"name":"Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz , Mainz 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