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Updated: Mar 12, 2026

Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
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Categorization of Patients with Peripheral Artery Disease by Charlson Comorbidity Index

Max Meertens1, Volker H Schmitt1,2, Igli Kalaja1

  • 1University Medical Centre of the Johannes Gutenberg University, Department of Cardiology, Mainz, Germany.

European Journal of Preventive Cardiology
|March 11, 2026
PubMed

Insights

Peripheral artery disease (PAD) patients show increasing comorbidity burden. Higher burden, measured by the Charlson Comorbidity Index (CCI), significantly elevates risks for major adverse events and mortality.

Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Geriatrics

Background:

  • Peripheral artery disease (PAD) is a significant cause of atherosclerotic morbidity.
  • The impact of comorbidity burden on PAD patient prognosis is often underestimated.
  • The Charlson Comorbidity Index (CCI) is a standard measure for assessing comorbidity burden.

Purpose of the Study:

  • To analyze trends in comorbidity burden among PAD patients in Germany.
  • To evaluate the association between comorbidity burden and clinical outcomes in PAD.
  • To inform clinical practice regarding comorbidity management in PAD.

Main Methods:

  • Utilized German nationwide inpatient data from 2005-2022 for PAD hospitalizations.
  • Categorized patients into CCI classes: mild (1-2), moderate (3-4), and high severity (>4).
  • Analyzed trends in CCI class distribution and its correlation with treatment and outcomes.

Main Results:

  • Over 3 million PAD hospitalizations were analyzed, with 55.4% in the high-severity CCI class by 2022.
  • Comorbidity burden and high-severity CCI class prevalence increased from 2006 to 2022.
  • Higher CCI class correlated with increased endovascular treatment, and significantly elevated risks for MACCE (OR 9.66), amputation (OR 2.82), and in-hospital mortality (OR 9.87).

Conclusions:

  • PAD patient comorbidity burden has risen in Germany between 2005-2022.
  • Elevated CCI scores in PAD patients are linked to a nearly 10-fold increased risk of MACCE and mortality.
  • Optimizing comorbidity management is crucial for improving PAD patient outcomes and preventing complications.
Abstract

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