Link to the University of Pittsburgh Homepage
Link to the University Library System Homepage Link to the Contact Us Form

Prevalence of Peripheral Artery Disease Among Adults with Sepsis

Iyer, Stuthi S. (2023) Prevalence of Peripheral Artery Disease Among Adults with Sepsis. Master Essay, University of Pittsburgh.

[img] PDF
Restricted to University of Pittsburgh users only until 17 May 2025.

Download (669kB) | Request a Copy


Introduction: Sepsis is common, deadly, and exacerbated by comorbid conditions. Peripheral artery disease (PAD) is one such condition, affecting >230 million people worldwide. PAD can lead to de novo ischemic wounds and retarded wound healing, that increase the risk of sepsis. We aimed to establish the prevalence of PAD among sepsis hospitalizations and hypothesized PAD would be associated with higher risk of in-hospital mortality and amputation among sepsis hospitalizations.

Methods: We conducted a retrospective, secondary analysis of discharge data from the 2018 National Inpatient Sample (NIS). NIS data with survey-weights generates national sepsis admission population prevalence estimates. We included hospitalizations with a primary diagnosis of sepsis and excluded non-adult patients (<18 years), and those with missing outcome (i.e., in-hospital mortality) and demographic (i.e., age, sex, race/ethnicity) data. Associations between PAD and in-hospital mortality or amputation among sepsis hospitalizations were evaluated using log-binomial regression, adjusting for demographics (age, race/ethnicity, sex, income) and a modified Elixhauser Comorbidity Index, which excluded peripheral vascular diseases.

Results: Of 35,527,481 hospitalizations (age mean ± standard error (SE): 49.9±0.2, 44% male, 65% White), 1,955,275 (5.5%, 95% confidence interval (CI): 5.4-5.6%) had a primary diagnosis of sepsis (age: 68.8±0.1, 50% male, 70% White); of which, 9,105 (0.5%, 95% CI 0.44-0.49%) had a secondary diagnosis of PAD (age: 71.1±0.3, 62% male, 67% White). Among sepsis hospitalizations, 10% had in-hospital mortality and 0.3% a major or transmetatarsal amputation. PAD was associated with a 14% higher risk of in-hospital mortality (95% CI: 1.01-1.29) and 24 times the risk of major or transmetatarsal amputation (95% CI: 19.7-29.0).

Conclusions: Among sepsis hospitalizations, comorbid PAD was infrequent. When present, PAD was associated with significantly higher risk of in-hospital mortality and major or transmetatarsal amputation, even after adjusting for demographics and the modified Elixhauser Comorbidity Index. Understanding the risks of in-hospital mortality and amputation among sepsis hospitalizations may inform high-risk subgroups that may need additional and more intensive care and interventions to prevent limb and life loss.


Social Networking:
Share |


Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Iyer, Stuthi S.ssi6@pitt.edussi60000-0002-5229-5790
ContributionContributors NameEmailPitt UsernameORCID
Committee MemberMarron, Megan M.mmm133@pitt.edummm133UNSPECIFIED
Committee MemberSeymour, Christopher W.seymourc@pitt.eduseymourcUNSPECIFIED
Committee MemberTzeng, Edithtzenge@upmc.eduUNSPECIFIEDUNSPECIFIED
Date: 17 May 2023
Date Type: Completion
Number of Pages: 76
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 17 May 2023 14:25
Last Modified: 17 May 2023 14:25


Monthly Views for the past 3 years

Plum Analytics

Actions (login required)

View Item View Item