"No more amputations": a complex scientific problem and a challenge for effective preventive strategy implementation...

Area of Science:

• Vascular Surgery
• Public Health
• Epidemiology

Background:

• Lower limb vascular amputations pose a significant challenge in vascular care, frequently resulting from critical limb ischemia, particularly in diabetic patients.
• Preventing limb loss is a crucial healthcare objective, necessitating a thorough understanding of amputation scenarios for effective strategy development.
• Amputation incidence data exhibits considerable international and regional variability due to diverse methodologies, population demographics, socioeconomic factors, and disparities in vascular care.

Purpose of the Study:

• To highlight the critical nature of lower limb vascular amputations and their association with critical limb ischemia and diabetes.
• To emphasize the importance of understanding amputation complexity for planning and implementing preventive strategies.
• To discuss lower limb amputations as a healthcare quality indicator, acknowledging limitations in provider actionability.

Main Methods:

• Review of existing literature on lower limb amputation incidence and trends.
• Analysis of factors contributing to variability in amputation data reporting.
• Discussion of the role of lower limb amputations as a healthcare quality indicator.

Main Results:

• Significant variability exists in reported amputation incidence rates globally and regionally.
• Factors influencing this variability include differing calculation methods, population characteristics, socioeconomic conditions, and healthcare access.
• Lower limb amputations serve as a healthcare quality indicator but have limitations regarding provider interventionability.

Conclusions:

• Effective prevention of lower limb vascular amputations requires early recognition of peripheral arterial disease and prompt referral to specialized vascular care.
• Emphasis should be placed on robust vascular risk factor management and multidisciplinary team collaboration.
• Addressing the lifetime risk associated with lower limb amputations necessitates not only effective revascularization but also proactive preventive measures.