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The effect of arterial reconstruction on lower limb amputation rate. An epidemiological survey based on reports from
Insights
Lower limb arteriosclerosis admissions and amputations increase with age and are higher in men. Arterial reconstructions did not prevent amputations, likely due to limited vascular surgery capacity in Denmark.
Area of Science:
- Vascular Surgery
- Epidemiology
- Public Health
Background:
- Lower limb arteriosclerosis is a significant health concern.
- Age and sex are known risk factors for peripheral artery disease.
- Understanding treatment patterns is crucial for resource allocation.
Purpose of the Study:
- To determine the incidence of lower limb arteriosclerosis admissions, amputations, and arterial reconstructions in Denmark.
- To analyze age, sex, and regional variations in these outcomes.
- To assess the effectiveness of arterial reconstructions in preventing amputations.
Main Methods:
- Utilized data from the Danish National Patient Register (April-December 1976).
- Calculated incidence rates for admissions, amputations, and arterial reconstructions.
- Analyzed data stratified by age, sex, and county.
Main Results:
- Admissions and amputations increased significantly with age.
- Incidence rates were 1.5 times higher in men than in women.
- Arterial reconstructions showed no correlation with amputation rates, suggesting insufficient surgical capacity.
Conclusions:
- Despite rising rates of lower limb arteriosclerosis, arterial reconstruction capacity in Denmark was inadequate.
- The study highlights a gap between the need for and provision of vascular surgery services.
- Further investigation into surgical capacity and patient outcomes is warranted.
Abstract:
During the period 1 April-31 December 1976, the incidence rates of admission, of amputation and of arterial reconstruction for arteriosclerosis of the lower limbs were calculated from information in the Danish National Patient Register. Admissions increased with age (from 4.3 per 100,000 persons under 40 years of age per year to 1603 per 100.000 persons over 80 years per year). Similarly, lower limb amputations varied with age (from 0.3 to 226 per 100.000 persons per year). Arterial reconstructions, however, did not vary with age, but remained rather constant at about 50 per 100.000 persons per year, in persons over 50 years. The incidence rates of admissions, amputations and arterial reconstructions in men were 1.5 x the incidence rates in women. Both amputation and arterial reconstruction showed a significant regional variation from county to county. However, the rates were not correlated, and the expected amputation-preventing-effect of arterial reconstructions could not be demonstrated. The most probable cause for this was the inadequate capacity for vascular surgery in Denmark. An estimation shows that of the 1100 operated on for severe lower limb ischemia during the period studied, only 290 were offered arterial reconstruction.