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Related Concept Videos

Peripheral Artery Disease I: Introduction01:30

Peripheral Artery Disease I: Introduction

Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses, temperature changes,...
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Diabetic Foot Ulcer01:31

Diabetic Foot Ulcer

Definition A diabetic foot ulcer (DFU) is a chronic, non-healing wound that develops in individuals with diabetes. It typically occurs on pressure-bearing areas such as the heel, metatarsal heads, or hallux, and carries a high risk of infection and amputation.Pathophysiology • The development of DFUs can be explained by four interconnected mechanisms: neuropathy, ischemia, infection, and impaired wound healing. • Neuropathy is the most common factor. Sensory neuropathy reduces pain perception,...

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Related Experiment Video

Updated: Jul 7, 2026

Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
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AMPREDICT MoRe: Predicting Mortality and Re-amputation Risk after Dysvascular Amputation.

Daniel C Norvell1, Alison W Henderson2, Aaron J Baraff3

  • 1VA Puget Sound Health Care System, Seattle, WA, USA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA; VA Centre for Limb Loss and Mobility (CLiMB), Seattle, WA, USA.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|February 17, 2025
PubMed
Summary

A new model, AMPREDICT MoRe, predicts death and re-amputation after dysvascular amputation using electronic health record data. This tool aids in amputation level decision-making, improving patient outcomes.

Keywords:
AmputationDeathDysvascularMortalityPredictionRe-amputation

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Area of Science:

  • Vascular Surgery
  • Health Informatics
  • Predictive Analytics

Background:

  • Dysvascular amputation, often due to diabetes and peripheral arterial disease, carries significant risks of mortality and re-amputation.
  • Existing prediction models face implementation barriers due to data requirements.
  • Electronic Health Records (EHR) offer a rich, accessible data source for clinical prediction.

Purpose of the Study:

  • To develop and validate a novel prediction model, AMPREDICT MoRe, for death and re-amputation post-dysvascular amputation.
  • To utilize only readily available EHR predictors to overcome implementation barriers.
  • To support clinical decision-making at the time of amputation level selection.

Main Methods:

  • Retrospective cohort study of 9,221 patients undergoing incident unilateral dysvascular amputation (transmetatarsal, transtibial, or transfemoral).
  • Utilized Veterans Affairs Corporate Data Warehouse data from October 2015 to September 2021.
  • Employed multinomial logistic regression and LASSO (least absolute shrinkage and selection operator) for variable selection and model fitting.
  • External validation performed on 20% of the cohort.

Main Results:

  • The final AMPREDICT MoRe model included 23 EHR-based predictors.
  • Observed outcome distributions: No Death/No Re-amputation (57.7%), No Death/Re-amputation (22.9%), Death/No Re-amputation (14.3%), Death/Re-amputation (5.1%).
  • Model demonstrated moderate overall discrimination (M index 0.70), with stronger prediction for death (0.79) than re-amputation (0.67), and best discrimination between no adverse outcomes and both adverse outcomes (0.82).

Conclusions:

  • The AMPREDICT MoRe model is successfully developed and validated for predicting death and re-amputation after dysvascular amputation.
  • Its reliance on EHR data facilitates practical application in clinical settings.
  • Future decision support tools can be developed without requiring patient interviews, streamlining clinical workflows.