West Michigan Cardiologist: Restoring Blood Flow Improves Survival Rates, Decreases Healthcare Costs Compared with Amputation
Grand Rapids, Michigan, Sept. 17, 2018 – Patients with peripheral artery disease may survive longer and pay less money when opting for treatments that restore blood flow to their limbs instead amputation, according to a groundbreaking study led by West Michigan interventional cardiologist Dr. Jihad Mustapha.
The study, “Determinants of Long-Term Outcomes and Costs in the Management of Critical Limb Ischemia: A Population-Based Cohort Study,” is the first study to investigate long-term outcomes and costs associated with treatment of first major CLI. It was sponsored by the CLI Global Society and published in the Journal of the American Heart Association¾just in time for PAD Awareness Month in September.
“Many patients diagnosed with critical limb ischemia are told amputation is their only option, but amputation is associated with many poor outcomes, including shorter survival, depression and loss of independence.” said Mustapha, co-founder and cardiologist at Advanced Cardiac & Vascular Amputation Prevention Centers, which he and co-founder Dr. Fadi Saab opened in early 2018.
“This study underscores what we have known intuitively for years: outcomes are better – and costs are lower – when we avoid amputation.”
The 22-page paper revealed and explored three major issues:
- CLI is a serious problem that threatens both life and limb. Patients with CLI suffer poor long-term prognosis and often need subsequent major amputation, which leads to higher healthcare costs.
- Revascularization and attempts to salvage the limb are effective in both saving limbs and reducing mortality.
- Considerable efforts are needed to raise disease awareness. Establishing a medical diagnosis code for CLI, which currently does not exist, would better define and allow physicians to identify and treat the disease.
In collaboration with members of the board of the CLI Global Society, including Drs. Barry T. Katzen, president; Richard F. Neville, Robert A. Lookstein, Thomas Zeller and Michael R. Jaff, Mustapha reviewed medical records of more than 72,000 Medicare patients diagnosed with primary CLI between 2010 and 2015. Medicare is the primary payer for roughly 75 percent of CLI-related hospitalizations, thus representing an average sampling of outcomes nationally.
The study found that 29 percent of patients with CLI will either die or have an amputation within the first year of diagnosis. Survival rates throughout the four years of the study were 38 percent for those with endovascular revascularization, 40 percent for those with surgical revascularization and 23 percent for those who had a major amputation.
Additionally, the study found that healthcare costs during follow-up associated with endovascular revascularization were $49,700, while surgical revascularization was $49,200. Costs for a major amputation were 12 percent higher at $55,700.
“Amputation is not the only solution, so it’s critical that people always get a second opinion,” Mustapha said. “By doing simple due diligence, limbs – and lives – can be saved. With the proper treatment for CLI, patients are given back control of their health.”
Mustapha and the CLI Global Society have done expansive work leading up to this publication and have intention of moving forward in obtaining recognition of CLI in the United States as a disease through a CLI-specific coding designation. Ideally, this will result in hospital systems initiating programs that identify and manage patients with CLI, recognizing that multi-disciplinary care is necessary to improve care of patients suffering from this disease.
To read the full study, visit ahajournals.org/doi/10.1161/JAHA.118.009724. For more information about the CLI Global Society, visit cliglobalsociety.org. To learn more about ACV, visit acvcenters.com.
About ACV Centers
Launched in February 2018, Advanced Cardiac & Vascular Amputation Prevention Centers provides highly personalized and comprehensive cardiac, vascular and vein care. Co-founded by Dr. Jihad Mustapha and Dr. Fadi Saab, ACV Centers has a special concentration on treating peripheral artery disease, or PAD, and the complications of critical limb ischemia, or CLI. For more information, visit www.acvcenters.com.