Abstract 10058: Increased Prevalence and Worsened Outcomes of Peripheral Vascular Disorders Hospitalizations in Young Adults: A National Decade Apart Analysis, 2007 vs. 2017

Abstract

Background: Prevalence and trends in peripheral vascular disease (PVD) admissions among young adults have been infrequently evaluated on a large scale. We aimed to study the demographics, comorbidities, and outcomes of PVD in young adults from data selected from two nationwide cohorts a decade apart (2007 vs 2017). Methods: We queried National Inpatient Sample (2007 & 2017) to identify PVD admissions among young adults (18-44 years) and compare the burden, demographics, comorbidities between 2017 and 2007 cohorts. Primary outcomes were all cause mortality, MACE (all-cause mortality, AMI, cardiogenic shock, cardiac arrest, ventricular fibrillation/flutter, pulmonary embolism, coronary intervention) and stroke, and secondary outcomes were hospital resource utilization. Results: There was an increase in young PVD hospitalizations in 2017 (0.5%/n=46,760) vs. 2007 (0.4% /n=37,099). The 2017 cohort often included younger (37 vs 40 years), white (54.8% vs 57.7%), female (48.6% vs 47.5%), Medicaid enrollees admitted non-electively (85.2% vs 80.0%) (p<0.05) vs. 2007 cohort. Comorbidities like smoking, drug abuse, fluid and electrolyte disorders, and pulmonary circulation disorders were the most frequent comorbidities in 2017 cohort vs. 2007 cohort. Despite lower rate of hypertension, renal failure, hyperlipidemia, complicated diabetes decreased in young PVD admissions from 2007 to 2017 (p<0.001), there was alarming increase in all-cause mortality (1.5% vs 3.4%, aOR1.39, 95%CI:1.23-1.59) and stroke (4.2% vs. 10.4%, aOR2.43, 95%CI:2.25-2.63) on adjusted multivariable analysis (p<0.001) with comparable MACE (8.9% vs 10.4%, aOR0.99, p=0.697) in 2017 vs. 2007. There was fewer routine discharges, prolonged hospital stay and charges in 2017 PVD cohort. Conclusion: The comparison of two national cohorts selected a decade apart showed an increased frequency of admissions of young PVD with higher substance abuse and higher all-cause mortality and stroke.