A Retrospective Risk-Factor Analysis of Patients Presenting With Peripheral Vascular Disease in a Tertiary Care...

Background Peripheral vascular disease (PVD) encompasses both upper and lower limb diseases affecting veins and arteries. This study focuses on peripheral arterial disease (PAD) due to its higher morbidity and mortality rates related to cardiovascular deaths. Research is crucial to assess the prevalence, risk factors, and burden of PVD in the Indian population. There is a significant lack of data on PVD in the northeastern region of India; therefore, this study aims to examine the risk factors for PVD in patients attending a tertiary care hospital in Northeast India. Methods This hospital-based case-control study, conducted in both retrospective and prospective modes, aimed to identify risk factors in patients with PVD. The study was carried out in a tertiary care teaching hospital in Northeast India from January 2015 to January 2025. The cases were patients with PVD (Group A), and the controls were healthy volunteers without PVD (Group B). The study extended over a period of 10 years (January 2015-January 2025) and included retrospective data (January 2015-October 2020) from hospital records and prospective data (October 2020-January 2025) from a questionnaire survey and follow-ups, analysing disease progression and treatment outcomes. Using a structured proforma, data were collected on sociodemographic details, symptoms, co-morbidities, substance misuse, and other relevant factors. The data was analyzed using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States). Results A total of 172 cases and 688 controls, in a 1:4 ratio, participated in the study. Hypertension, diabetes mellitus, smoking history, and cardiac ailments were significantly higher among cases than controls (p<0.05). Among smokers, the number of cigarettes per day and smoking duration were significantly associated with peripheral vascular disease. When smoking was combined with diabetes mellitus and hypertension, the risk of developing peripheral vascular disease increased significantly. Atherosclerosis below the aortic bifurcation was found in 104 patients (60.47%), making it the most common vascular pathology, followed by thromboangiitis obliterans in 63 patients (36.63%). Multivariate logistic regression analysis identified male gender (OR: 1.27, 95%CI: 0.019 to 0.231, p=0.01), smoking history (OR: 1.91, 95%CI: 0.638 to 0.972, p=0.001), number of cigarettes smoked per day (OR: 1.64, 95%CI: 0.473 to 0.816, p=0.002), diabetes mellitus (OR: 3.68, 95%CI: 0.488 to 1.368, p=0.000), and hypertension (OR: 2.17, 95%CI: 0.798 to 1.131, p=0.000) as independent risk factors for peripheral vascular disease. Amputation was the most common treatment offered, followed by rehabilitation. Bone marrow cell therapy was attempted in 21 patients, avoiding amputation in 17. Conclusion This result demonstrates smoking, diabetes mellitus, and hypertension as region-specific independent risk factors for PVD in Northeast India. These findings focus on the importance of reducing risk factors in patients with diabetes for the prevention of PVD.