A comprehensive scoring system to evaluate patient-centred risk factors regarding lower extremity amputation

Area of Science:

• Podiatric medicine
• Surgical decision-making
• Patient-centered care

Background:

• Lower extremity wounds present complex challenges, often leading to amputation based on surgeon perception rather than patient-centered factors.
• Current decision-making for limb-threatening wounds may not adequately incorporate patient-centered considerations, potentially impacting long-term outcomes.
• Recurrence of wound issues after treatment can lead to further complications, including amputation.

Purpose of the Study:

• To review considerations and recommendations for lower extremity amputation, including short- and long-term implications.
• To address the need for objective criteria in amputation decision-making, incorporating patient-centered issues.
• To introduce the Miller-Newgent Amputation Scale (MENACE) as a tool for evaluating factors in lower extremity amputation.

Main Methods:

• Review of existing literature on lower extremity amputation considerations.
• Development of a set of patient-centered, verifiable criteria for amputation evaluation.
• Introduction of the Miller-Newgent Amputation Scale (MENACE) for decision support.

Main Results:

• Existing approaches to lower extremity amputation decisions are often based on healthcare professional perceptions.
• There is a significant need for a standardized, patient-centered approach to amputation decision-making.
• The proposed MENACE provides a framework to evaluate both medical and patient-centered issues.

Conclusions:

• The Miller-Newgent Amputation Scale (MENACE) aims to improve decision-making for lower extremity amputation.
• MENACE focuses on patient-centered issues to enhance short- and long-term physical and quality-of-life outcomes.
• Implementing MENACE can lead to more informed and patient-aligned amputation decisions.