Vascular surgical audit-arterial reconstructions and amputations for lower limb ischaemia

There were 750 arterial reconstructions and 2134 major amputations in hospitals within the South West Regional Health Authority (SWRHA) from 1974-1978, according to a Hospital Activity Analysis (HAA) based survey of all patients undergoing these operations for atherosclerotic limb ischaemia. Those undergoing arterial reconstruction fared better than amputees in terms of hospital mortality (5.2% vs. 21%) and length of hospital stay (21.4 days vs. 47 days). Comparison of the HAA results with case records and operating theatre books at Bristol Royal Infirmary showed a failure-of-inclusion rate of 10% for arterial reconstructions and 9.3% for amputations. There was a difference in the proportion of arterial reconstructions to major amputations (2.5:1) at Bristol Royal Infirmary compared with SWRHA hospitals (1:3), but hospital stay and operative mortality were similar.