Association Between Underweight Body Mass Index and In-Hospital Outcome in Patients Undergoing Endovascular Interventions for Peripheral Artery Disease: A Propensity Score Matching Analysis.

MedStar author(s):
Citation: Journal of Endovascular Therapy. 26(3):411-417, 2019 06.PMID: 30931727Institution: MedStar Washington Hospital CenterDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Body Mass Index | *Endovascular Procedures | *Peripheral Arterial Disease/th [Therapy] | *Thinness/di [Diagnosis] | Aged | Aged, 80 and over | Comorbidity | Databases, Factual | Endovascular Procedures/ae [Adverse Effects] | Endovascular Procedures/is [Instrumentation] | Endovascular Procedures/mo [Mortality] | Female | Health Status | Hospital Mortality | Humans | Male | Middle Aged | Nutritional Status | Peripheral Arterial Disease/dg [Diagnostic Imaging] | Peripheral Arterial Disease/mo [Mortality] | Propensity Score | Retreatment | Retrospective Studies | Risk Assessment | Risk Factors | Severity of Illness Index | Stents | Thinness/mo [Mortality] | Thinness/pp [Physiopathology] | Treatment Outcome | United StatesYear: 2019ISSN:
  • 1526-6028
Name of journal: Journal of endovascular therapy : an official journal of the International Society of Endovascular SpecialistsAbstract: CONCLUSION: Low-BMI patients with PAD have worse in-hospital survival and more adverse outcomes after EVT.MATERIALS AND METHODS: Using weighted data from the National Inpatient Sample (NIS) database between 2002 and 2014 and ICD-9 codes, 2614 patients were identified who were aged >=18 years and underwent EVT for PAD in the lower limb vessels. EVT was defined as angioplasty, atherectomy, and/or stenting. After excluding individuals with BMI >24, there were 807 (31%) normal-weight (BMI 19-24) patients and 1807 (69%) underweight (BMI <19) individuals. All patients in both groups were matched for baseline demographic and clinical characteristics and critical limb ischemia in a 1:1 propensity score matching analysis using the nearest neighbor method.PURPOSE: To investigate in-hospital outcomes after endovascular therapy (EVT) in patients with severe peripheral artery disease (PAD) who had a low body mass index (BMI, kg/m<sup>2</sup>) compared to those with normal BMI.RESULTS: Propensity score matching produced 2 groups of 685 patients that differed only in the incidence of chronic lung disease, which was more frequent in low-BMI patients (p=0.04). Patients with low BMI had a higher incidence of in-hospital mortality (4.8% vs 1.2%, p<0.001), major adverse cardiovascular events (composite of death, myocardial infarction, or stroke) (7.9% vs 4.1%, p=0.003), open bypass surgery (9.1% vs 6.0%, p=0.03), and infection (14.6% vs 10.5%, p=0.02) compared with the normal-BMI group. There was no significant difference in the incidence of vascular complications (p=0.31), major bleeding (p=0.17), major amputation (p=0.35), or acute kidney injury (p=0.09) between the low- and normal-BMI groups.All authors: Al-Khadra Y, Alraies MC, Darmoch F, Kaki A, Mamas MA, Moussa Pacha H, Soud MOriginally published: Journal of Endovascular Therapy. 26(3):411-417, 2019 Jun.Fiscal year: FY2019Digital Object Identifier: ORCID: Date added to catalog: 2019-06-21
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Journal Article MedStar Authors Catalog Article 30931727 Available 30931727

CONCLUSION: Low-BMI patients with PAD have worse in-hospital survival and more adverse outcomes after EVT.

MATERIALS AND METHODS: Using weighted data from the National Inpatient Sample (NIS) database between 2002 and 2014 and ICD-9 codes, 2614 patients were identified who were aged >=18 years and underwent EVT for PAD in the lower limb vessels. EVT was defined as angioplasty, atherectomy, and/or stenting. After excluding individuals with BMI >24, there were 807 (31%) normal-weight (BMI 19-24) patients and 1807 (69%) underweight (BMI <19) individuals. All patients in both groups were matched for baseline demographic and clinical characteristics and critical limb ischemia in a 1:1 propensity score matching analysis using the nearest neighbor method.

PURPOSE: To investigate in-hospital outcomes after endovascular therapy (EVT) in patients with severe peripheral artery disease (PAD) who had a low body mass index (BMI, kg/m<sup>2</sup>) compared to those with normal BMI.

RESULTS: Propensity score matching produced 2 groups of 685 patients that differed only in the incidence of chronic lung disease, which was more frequent in low-BMI patients (p=0.04). Patients with low BMI had a higher incidence of in-hospital mortality (4.8% vs 1.2%, p<0.001), major adverse cardiovascular events (composite of death, myocardial infarction, or stroke) (7.9% vs 4.1%, p=0.003), open bypass surgery (9.1% vs 6.0%, p=0.03), and infection (14.6% vs 10.5%, p=0.02) compared with the normal-BMI group. There was no significant difference in the incidence of vascular complications (p=0.31), major bleeding (p=0.17), major amputation (p=0.35), or acute kidney injury (p=0.09) between the low- and normal-BMI groups.

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