Leg Amputations Show Dramatic Decline

The number of amputations of lower extremities among patients with peripheral artery disease has been going down, though there remain regional and racial differences, according to Nancy Walsh, staff writer for MedPage Today. The rate of amputation declined from 7, 258 per 100, 000 patients in 2000 to 5, 790 per 100, 000 in 2008.

The research was carried out by W. Schuler Jones, M.D. and his colleagues from Duke University, who reported on their work in the Journal of the American College of Cardiology. They reviewed records from the Centers for Medicare and Medicaid Services and identified about 3 million individuals who were hospitalized for peripheral artery disease during the study period. Among these, 186, 338 had a lower extremity amputation.

The researchers also found regional variations. The rates of amputation ranged from 8, 400 per 100, 000 patients living in the Southeastern area of the country to 5, 500 per 100, 000 in the Mountain states.

Amputations were more likely to take place among patients who were black, who had kidney disease and who had diabetes, the researchers reported. After adjustment for clinical factors, changes over time, and clustering at the census level, amputations were found to be more common in the South Central states compared with the South Atlantic region. Amputation was less likely in the Mid-Atlantic States, New England, and the North Central states.

The authors suggest that “unmeasured effects of socioeconomic status, access, and application of care may contribute to the risk of amputation.” Their study demonstrates the critical need for education programs for clinicians and patients that will focus on best practices for the prevention and treatment of peripheral artery disease, Walsh wrote.