Impact of Dementia on Treatment of Peripheral Arterial Disease, Hip and Vertebral Bone Fracture

Objectives: We hypothesis that dementia impact treatment strategy in cases hospitalized for advanced Peripheral Arterial Disease (PAD), Hip Fracture (HF) and Vertebral Bone Fracture (VF) in Germany. Patients and Methods: Detailed lists of cases hospitalized with the principal diagnosis PAD, HF and VF in the year 2019 were provided by the Federal Statistical Office. In addition, cases were separated by the additional diagnosis dementia and surgical treatment procedures. Results: In 2019, there were 166,244 cases hospitalized for HF, 69,888 with VF and 74,910 with PAD. The rate of cases with the additional diagnosis dementia were 18.2%, 7.7% and 7.1%. In HF cases most frequent surgical treatment was hip arthroplasty in both, cases with (37%) and cases without dementia (34%). In VF cases conservative treatment was the dominant treatment strategy with 70% in those without and 81% in those with dementia. In PAD cases conservative treatment was the dominant treatment strategy with 74% in those without and 67% in those with dementia. Mayor amputation (7% vs 14%) was performed more frequently in those with dementia, but not minor amputation (19% vs 19%). Conclusion: Our analysis supports the hypothesis, that dementia impacts treatment decisions in older patients suffering from HF, VF and PAD in Germany in different ways. In cases with dementia more cases with VB were treated conservatively and in case of HF more cases surgically. In cases with advanced PAD more major amputation were performed.