Trends in Major Lower Limb Amputation Related to Peripheral Arterial Disease in Hungary

A Nationwide Study (2004-2012)

E. Kolossváry, T. Ferenci, T. Kováts, L. Kovács, Z. Járai, G. Menyhei, K. Farkas

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objectives To assess the trends of peripheral arterial disease associated major lower limb amputation in Hungary over a 9 year period (2004-2012) in the whole Hungarian population. Methods This was a retrospective cohort study employing administrative health care data. Major amputations were identified in the entire Hungarian population during a 9 year period (2004-2012) using the health care administrative data. Direct standardization was used to eliminate the potential bias induced by the different age and sex structure of the compared populations. For external direct standardization, the ESP 2013 was chosen as reference. Results 76,798 lower limb amputations were performed. The number of major amputations was 38,200; these procedures affected 32,084 patients. According to case detection, 50.4% of the amputees were diabetic. The overall primary amputation rate was 71.5%. The annual crude and age adjusted major amputation rates exhibited no significant long-term pattern over the observation period. The major lower limb amputation incidence for the overall period was 42.3/105 in the total population and 317.9/105 in diabetic population. Conclusion According to this whole population based study from Hungary, the incidence of lower limb major amputation is high with no change over the past 9 years. An explanation for this remains to be determined, as the traditional risk factors in Hungary do not account for it. The characteristics of major amputation (the rate of primary amputation, the ratio of below to above knee amputation and the age of the affected population) underline the importance of screening, early detection, improved vascular care and an optimal revascularization policy. Standardization and validation of amputation detection methods and reporting is essential.

Original languageEnglish
Article number5695
Pages (from-to)78-85
Number of pages8
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume50
Issue number1
DOIs
Publication statusPublished - Jul 1 2015

Fingerprint

Hungary
Peripheral Arterial Disease
Amputation
Lower Extremity
Population
Cohort Studies
Delivery of Health Care
Amputees
Blood Vessels
Knee
Retrospective Studies
Observation

Keywords

  • Critical limb ischemia
  • Lower limb amputation
  • Peripheral arterial disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Medicine(all)

Cite this

Trends in Major Lower Limb Amputation Related to Peripheral Arterial Disease in Hungary : A Nationwide Study (2004-2012). / Kolossváry, E.; Ferenci, T.; Kováts, T.; Kovács, L.; Járai, Z.; Menyhei, G.; Farkas, K.

In: European Journal of Vascular and Endovascular Surgery, Vol. 50, No. 1, 5695, 01.07.2015, p. 78-85.

Research output: Contribution to journalArticle

Kolossváry, E. ; Ferenci, T. ; Kováts, T. ; Kovács, L. ; Járai, Z. ; Menyhei, G. ; Farkas, K. / Trends in Major Lower Limb Amputation Related to Peripheral Arterial Disease in Hungary : A Nationwide Study (2004-2012). In: European Journal of Vascular and Endovascular Surgery. 2015 ; Vol. 50, No. 1. pp. 78-85.
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abstract = "Objectives To assess the trends of peripheral arterial disease associated major lower limb amputation in Hungary over a 9 year period (2004-2012) in the whole Hungarian population. Methods This was a retrospective cohort study employing administrative health care data. Major amputations were identified in the entire Hungarian population during a 9 year period (2004-2012) using the health care administrative data. Direct standardization was used to eliminate the potential bias induced by the different age and sex structure of the compared populations. For external direct standardization, the ESP 2013 was chosen as reference. Results 76,798 lower limb amputations were performed. The number of major amputations was 38,200; these procedures affected 32,084 patients. According to case detection, 50.4{\%} of the amputees were diabetic. The overall primary amputation rate was 71.5{\%}. The annual crude and age adjusted major amputation rates exhibited no significant long-term pattern over the observation period. The major lower limb amputation incidence for the overall period was 42.3/105 in the total population and 317.9/105 in diabetic population. Conclusion According to this whole population based study from Hungary, the incidence of lower limb major amputation is high with no change over the past 9 years. An explanation for this remains to be determined, as the traditional risk factors in Hungary do not account for it. The characteristics of major amputation (the rate of primary amputation, the ratio of below to above knee amputation and the age of the affected population) underline the importance of screening, early detection, improved vascular care and an optimal revascularization policy. Standardization and validation of amputation detection methods and reporting is essential.",
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AB - Objectives To assess the trends of peripheral arterial disease associated major lower limb amputation in Hungary over a 9 year period (2004-2012) in the whole Hungarian population. Methods This was a retrospective cohort study employing administrative health care data. Major amputations were identified in the entire Hungarian population during a 9 year period (2004-2012) using the health care administrative data. Direct standardization was used to eliminate the potential bias induced by the different age and sex structure of the compared populations. For external direct standardization, the ESP 2013 was chosen as reference. Results 76,798 lower limb amputations were performed. The number of major amputations was 38,200; these procedures affected 32,084 patients. According to case detection, 50.4% of the amputees were diabetic. The overall primary amputation rate was 71.5%. The annual crude and age adjusted major amputation rates exhibited no significant long-term pattern over the observation period. The major lower limb amputation incidence for the overall period was 42.3/105 in the total population and 317.9/105 in diabetic population. Conclusion According to this whole population based study from Hungary, the incidence of lower limb major amputation is high with no change over the past 9 years. An explanation for this remains to be determined, as the traditional risk factors in Hungary do not account for it. The characteristics of major amputation (the rate of primary amputation, the ratio of below to above knee amputation and the age of the affected population) underline the importance of screening, early detection, improved vascular care and an optimal revascularization policy. Standardization and validation of amputation detection methods and reporting is essential.

KW - Critical limb ischemia

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