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Lower extremity amputations in Ireland: a registry-based study
Anna Mealy1, Sean Tierney2, Jan Sorensen3
1The Royal Hospital, Perth, Australia. mealyan@tcd.ie.
Insights
Establishing a national multi-disciplinary foot protection clinic could significantly reduce lower extremity amputations (LEAs), particularly among diabetic patients. This initiative offers substantial cost savings and improved patient health outcomes.
Area of Science:
- Podiatry
- Vascular Surgery
- Public Health
Background:
- Lower extremity amputations (LEAs) represent a significant burden on patient well-being and healthcare resources in Irish public hospitals.
- Diabetes is a major contributing factor to LEAs, necessitating targeted prevention strategies.
Purpose of the Study:
- To analyze patient characteristics associated with LEAs in Irish public hospitals between 2016-2019.
- To evaluate the potential cost savings and health benefits of implementing a national multi-disciplinary foot protection clinic (MDFPC).
Main Methods:
- Analysis of LEA patient characteristics using national hospital inpatient discharge data (2016-2019).
- Extrapolation of national consequences based on existing literature.
- Modeling potential savings from a 20% reduction in diabetic LEAs via an MDFPC.
Main Results:
- 3104 LEAs were recorded in Irish public hospitals from 2016-2019, with 68% being minor amputations.
- Diabetes was a primary diagnosis in 76% of minor and 52% of major LEAs.
- A national MDFPC could prevent 106 diabetic LEAs annually, saving nearly 3000 hospital bed days and €3 million.
Conclusions:
- LEAs have a profound impact on patients and strain hospital resources.
- Effective preventive strategies, such as a national MDFPC, can lead to significant health improvements and cost reductions.
Objective:
To analyse the current provision of lower extremity amputations (LEA) in Irish public hospitals by patient characteristics and assess the potential savings for reducing numbers if a national multi-disciplinary foot protection clinic (MDFPC) was established nation-wide.
Design And Data Sources:
Patient characteristics of LEA conducted during 2016-2019 were analysed based on discharge data from the national hospital inpatient enquiry system. Reported consequences from existing literature were used to extrapolate national consequences.
Results:
Public hospitals registered 3104 hospital admissions with LEA during 2016-2019. 68% (n = 2099) of these were minor amputations. About 76% (n = 1592) of minor amputations and 52% (n = 525) of major amputations were performed on patients with a diagnosis of diabetes. If the implementation of a national MDFPC programmed could reduce the number of diabetic amputations by 20%, 80 minor and 26 major amputations could be avoided annually. This would avoid nearly 3000 hospital bed days and correspond to a potential annual saving of €3 M.
Conclusion:
LEA has severe impact on patients' lives and hospital resources. Potential savings from effective prevention strategies may offer both health improvements and cost-savings.
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