C-58 | The In-Hospital Outcomes of Atherectomy for Peripheral Arterial Disease Among Obese and Non-Obese Patients: An Insight from the National Inpatient Sample Database

Abstract

Atherectomy is one of the treatment options for symptomatic peripheral arterial disease (PAD). Previous studies have revealed an obesity paradox for PAD patients, with better outcomes in obese than non-obese patients. The purpose was to compare the in-hospital outcomes among obese and non-obese patients undergoing atherectomy. We performed a cross-sectional analysis on 105320 patients who underwent atherectomy for PAD based on ICD-10-PCS codes during hospitalization from January 2016 to December 2018 using the National Inpatient Sample database. They were stratified into obese (BMI ≥ 30) and non-obese groups (BMI <30). The primary outcome was in-hospital mortality. 105190 patients were included in the study (<18 years of age excluded), with 15170 obese and 90020 non-obese. The observed in-hospital mortality was 2.5% and 3.5 % in obese and non-obese groups, respectively, with a p-value of <0.001. There was a higher proportion of patients with smoking in non-obese vs. obese group (28.8% vs. 23.8%). The difference in mortality disappeared after adjusting for confounding factors (2.5% vs. 2.8% in obese vs. non-obese with p-value of 0.11). The obese group continued to have higher hospitalization costs, and more patients required discharge to skilled nursing facility even after adjusting for confounders (Table 1). Smoking was the major confounder while adjusting for other factors didn’t make any difference. Our analysis did not show any difference in in-hospital mortality among obese and non-obese patients undergoing atherectomy for PAD. The obesity paradox needs to be further studied in context of intervention for PAD.