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SUN-069 Differences in Treatment of Peripheral Arterial Disease Procedures in Hospitalized Patients with Type 1 or 2 Diabetes

Abstract Introduction: Limited literature exists describing differences in treatment and outcomes following procedural admissions among individuals with peripheral arterial occlusive disease (PAD) based upon type of diabetes. Methods: Using the National (Nationwide) Inpatient Sample (NIS) database 2005 to 2014, we identified adult (age ≥ 18 years) diabetic patients with a diagnosis of PAD and a co-existing diagnosis of critical limb ischemia or intermittent claudication who underwent treatment procedures: open revascularization, endovascular revascularization or amputation. This unselected national cohort was then studied to analyze the differences in clinical characteristics, treatment procedures and outcomes based on presence of type of DM (Type 1 vs. Type 2). Results: Among 1,082,665 PAD related procedural admissions in diabetic population, 5.0% (n= 53,831) had Type 1 DM. Overall, Type 1 DM were younger, more likely to be white, males, have private insurance and less likely to have concurrent diagnoses of hypertension, smoking, dyslipidemia, coronary artery disease, congestive heart failure, atrial fibrillation, cerebrovascular disease and chronic pulmonary disease (all p <0.001). Type 1 DM group had significantly higher concurrent diagnoses of chronic renal failure. Type 1 DM patients were more likely to undergo amputation (60.7% vs. 47.9%, adjusted odds ratio = 1.39, 95% CI 1.35 to 1.42) and less likely to undergo endovascular (15.6% vs. 22.7%, adjusted odds ratio = 0.86, 95% CI 0.84 to 0.88) and open revascularization procedures (10.7% vs. 15.5%, adjusted odds ratio = 0.82, 95% CI 0.80 to 0.84). Overall in-hospital mortality was 1.8%; 1.9% in Type 1 and 1.8% in Type 2 DM. The overall median (IQR) length of stay (in days) was 7 (4 to 12); 8(5 to14) for Type 1 DM and 7(4 to 12) for Type 2 DM. Overall median hospitalization cost was 38,108 (20,110 to 72,328); 52, 659 (28,871 to 97, 209) for Type 1 DM and 52, 172 (30, 027 to 92, 824) for Type 2 DM. Conclusion: This is the first study to examine the differences in lower extremity PAD related procedural hospitalization based on type of diabetes. We observed that type 1 DM patients undergoing procedural hospitalizations were younger, preferentially were treated with amputations, and had higher length of stay when compared to those with type 2 DM.