Temporal Trends and Mortality Patterns in Peripheral Arterial Disease: A Comprehensive Analysis of Hospitalized Patients in Kazakhstan between 2014 and 2021

Zhakhina G. Sakko Y. Yerdessov S. Aimyshev T. Makhammajanov Z. Abbay A. Vinnikov D. Fakhradiyev I. Yermakhanova Z. Solak Y. Salustri A. Gaipov A.
December 2024 Springer Science and Business Media B.V.

Journal of Epidemiology and Global Health
2024 #14 Issue 4 1609 - 1618 pp.

Background: Peripheral artery disease (PAD) is a global health concern associated with arterial narrowing or blockage, leading to significant morbidity and mortality. The aim of this study is to assess the disease burden and trends in mortality utilizing nationwide administrative health data. Methods: This retrospective study utilized data from the Unified National Electronic Healthcare System (UNEHS) from 2014 to 2021. Patients meeting PAD criteria were included, with demographic and clinical data analyzed. Cox regression and Competing Risk Analysis assessed mortality risks. Results: Between 2014 and 2021, 19,507 individuals were hospitalized due to PAD, with 8,332 (43%) being women and 11,175 (57%) men. The incidence of PAD increased markedly over the observation period, rising from 79 individuals per million population (PMP) in 2014 to 309 PMP in 2021. Concurrent heart failure (HF), acute myocardial infarction (AMI), diabetes, and essential hypertension were prevalent in 50%, 27%, 27%, and 26% of the PAD patients, respectively. Competing Risk Analysis showed a subdistribution hazard ratio (SHR) of 6.53 [95% CI: 4.65–9.19] for individuals over 80 years. Heart failure was associated with lower all-cause HR [0.80, 95% CI: 0.76–0.86, p < 0.001] but higher SHR [1.30, 95% CI: 1.18–1.44, p < 0.001]. Comorbidities such as heart failure, stroke, and acute myocardial infarction significantly increased mortality risks, while essential hypertension was associated with lower risk of death. Conclusion: The significant rise in the incidence rate of PAD underscores the growing burden of the disease, highlighting the urgent need for targeted preventive and management strategies in Kazakhstan.

Charlson Comorbidity Index , Competing risk Analysis , Nationwide Administrative data , Peripheral Artery Disease (PAD) , Vascular Disease

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Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan
Environmental Health Lab, Al-Farabi Kazakh National University, Almaty, Kazakhstan
Occupational Health Risks Lab, Peoples’ Friendship University of Russia (RUDN University), Moscow, Russian Federation
Department of Medicine, Kazakh National Medical University, Almaty, Kazakhstan
Department of Special Clinical Disciplines, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan, Kazakhstan
Nefromed Private Hemodialysis Clinic, Sakarya, Turkey
Clinical Academic Department of Internal Medicine, University Medical Center, Astana, Kazakhstan
Astana city, Kazakhstan

Department of Medicine
Department of Biomedical Sciences
Environmental Health Lab
Occupational Health Risks Lab
Department of Medicine
Department of Special Clinical Disciplines
Nefromed Private Hemodialysis Clinic
Clinical Academic Department of Internal Medicine
Astana city

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