International Variations in Amputation Practice : A VASCUNET Report

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dc.contributor.author Behrendt, Christian-Alexander
dc.contributor.author Sigvant, Birgitta
dc.contributor.author Szeberin, Zoltan
dc.contributor.author Beiles, Barry
dc.contributor.author Eldrup, Nikolaj
dc.contributor.author Thomson, Ian A.
dc.contributor.author Venermo, Maarit
dc.contributor.author Altreuther, Martin
dc.contributor.author Menyhei, Gabor
dc.contributor.author Nordanstig, Joakim
dc.contributor.author Clarke, Mike
dc.contributor.author Riess, Henrik Christian
dc.contributor.author Björck, Martin
dc.contributor.author Debus, Eike Sebastian
dc.date.accessioned 2019-09-30T21:48:45Z
dc.date.available 2021-12-17T22:02:32Z
dc.date.issued 2018-09
dc.identifier.citation Behrendt , C-A , Sigvant , B , Szeberin , Z , Beiles , B , Eldrup , N , Thomson , I A , Venermo , M , Altreuther , M , Menyhei , G , Nordanstig , J , Clarke , M , Riess , H C , Björck , M & Debus , E S 2018 , ' International Variations in Amputation Practice : A VASCUNET Report ' , European Journal of Vascular and Endovascular Surgery , vol. 56 , no. 3 , pp. 391-399 . https://doi.org/10.1016/j.ejvs.2018.04.017
dc.identifier.other PURE: 116434446
dc.identifier.other PURE UUID: 5cb64975-17c0-45e5-b6dd-69b4de005d1b
dc.identifier.other WOS: 000444274900014
dc.identifier.other Scopus: 85047615504
dc.identifier.uri http://hdl.handle.net/10138/305687
dc.description.abstract Objectives: To study international differences in incidence and practice patterns as well as time trends in lower limb amputations related to peripheral arterial disease and/or diabetes mellitus. Methods: Data on lower limb amputations during 2010-2014 were collected from population based administrative data from countries in Europe and Australasia participating in the VASCUNET collaboration. Amputation rates, time trends, in hospital or 30 day mortality and reimbursement systems were analysed. Results: Data from 12 countries covering 259 million inhabitants in 2014 were included. Individuals aged >= 65 years ranged from 12.9% (Slovakia) to 20.7% (Germany) and diabetes prevalence among amputees from 25.7% (Finland) to 74.3% (Slovakia). The mean incidence of major amputation varied between 7.2/100,000 (New Zealand) and 41.4/100,000 (Hungary), with an overall declining time trend with the exception of Slovakia, while minor amputations increased over time. The older age group (>= 65 years) was up to 4.9 times more likely to be amputated compared with those younger than 65 years. Reported mortality rates were lowest in Finland (6.3%) and highest in Hungary (20.3%). Countries with a fee for service reimbursement system had a lower incidence of major amputation compared with countries with a population based reimbursement system (14.3/100,000 versus 18.4/100,000, respectively, p <.001). Conclusions: This international audit showed large geographical differences in major amputation rates, by a factor of almost six, and an overall declining time trend during the 4 year observation of this study. Diabetes prevalence, age distribution, and mortality rates were also found to vary between countries. Despite limitations attributable to registry data, these findings are important, and warrant further research on how to improve limb salvage in different demographic settings. (C) 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved. en
dc.format.extent 9
dc.language.iso eng
dc.relation.ispartof European Journal of Vascular and Endovascular Surgery
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Peripheral arterial disease (PAD)
dc.subject Diabetic foot syndrome (DFS)
dc.subject Lower extremity amputation
dc.subject Epidemiology
dc.subject Administrative data
dc.subject Registries
dc.subject LOWER-EXTREMITY AMPUTATIONS
dc.subject PERIPHERAL ARTERIAL-DISEASE
dc.subject CRITICAL LIMB ISCHEMIA
dc.subject EDITORS CHOICE
dc.subject COLLABORATION
dc.subject GUIDELINES
dc.subject NATIONWIDE
dc.subject PATTERNS
dc.subject SURGERY
dc.subject TRENDS
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title International Variations in Amputation Practice : A VASCUNET Report en
dc.type Article
dc.contributor.organization Verisuonikirurgian yksikkö
dc.contributor.organization Clinicum
dc.contributor.organization HUS Abdominal Center
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1016/j.ejvs.2018.04.017
dc.relation.issn 1078-5884
dc.rights.accesslevel openAccess
dc.type.version publishedVersion
dc.type.version draft

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