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Related Experiment Video

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Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
07:25

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Published on: September 22, 2020

Factors predicting resource utilization and survival after major amputation.

Antonia J Henry1, Nathanael D Hevelone, Alexander T Hawkins

  • 1Division of Vascular and Endovascular Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA.

Journal of Vascular Surgery
|January 15, 2013
PubMed
Summary

Major amputation leads to high healthcare resource utilization and mortality. Socioeconomic status did not significantly impact long-term outcomes, suggesting earlier interventions are key for critical limb ischemia.

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Area of Science:

  • Vascular Surgery
  • Health Services Research
  • Outcomes Research

Background:

  • Major amputation significantly increases short-term healthcare resource utilization (RU), mortality, and reveals socioeconomic status (SES) disparities.
  • Understanding long-term RU and survival predictors is crucial for optimizing patient care post-amputation.

Purpose of the Study:

  • To investigate patient-specific and SES-related predictors of long-term RU and survival following major amputation.
  • To analyze factors influencing cumulative length of stay (cLOS) and subsequent procedures.

Main Methods:

  • Retrospective analysis of 364 adult patients undergoing major amputation for critical limb ischemia (1995-2000).
  • Outcomes analyzed through December 2010, including comorbidities, subsequent procedures, cLOS, and mortality.
  • Statistical analysis employed Poisson regression and Cox proportional hazard modeling.

Main Results:

  • High RU observed, with significant cLOS, readmissions, and procedures post-amputation.
  • Younger age, public insurance, congestive heart failure (CHF), and renal failure (RF) associated with increased cLOS.
  • Older age, CHF, and RF were risk factors for decreased survival; SES factors were not significantly related to outcomes.

Conclusions:

  • High RU persists post-amputation, independent of SES.
  • SES may not be protective against poor outcomes when limb salvage is not possible.
  • Earlier interventions for critical limb ischemia are crucial for mitigating SES disparities.