Comparing Patient and Provider Priorities Around Amputation Level Outcomes Using Multiple Criteria Decision Analysis

Poehler, Diana; Czerniecki, Joseph M.; Norvell, Daniel C; Henderson, Alison W.; Devine, Beth

doi:10.1016/j.avsg.2023.05.026

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…Regular assessment of the residual limb's condition allows for early detection and prompt management of any issues, such as infection, delayed wound healing, or skin breakdown. Timely intervention can prevent complications and optimize the healing process [88]. Regular foot checks and preventive strategies reduced the incidence of foot ulcers in individuals with diabetes and a history of amputation [89].…”

Section: Establishingmentioning

confidence: 99%

Understanding Lower Limb Amputation: A Review of the Strategies for Healthcare Improvement, Prevention, and Management

Okesina,

Nsubuga,

Omoola

et al. 2024

rmj

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INTRODUCTION: Lower limb amputation (LLA) is a global health issue affecting millions of people worldwide. Factors such as diabetes, peripheral vascular disease, infections, and improper medical practices also contribute to Lower limb amputation. The personal, family, and socio-economic costs associated with amputation are substantial, emphasizing the need for preventive measures, improved healthcare resources, and support for amputees. METHODS: A literature review of Lower limb amputation and its associated risk factors, which focuses on hypertension, hypercholesterolemia, smoking, diabetic complications, Indigenous ethnicity, and foot infections. RESULTS: It was revealed that the socio-economic impact of Lower limb amputation includes job loss and financial burdens. Also, access to rehabilitation services, stigma, and marginalization further complicate the lives of amputees. Furthermore, peripheral vascular disease is a significant risk factor, and chronic hyperglycemia in diabetes leads to diabetic foot syndrome and subsequent amputations. Lower limb amputation has a profound impact on quality of life and psychological well-being, particularly in rural areas where manual labor is prevalent. Strategies to address Lower limb amputation include prevention and management of diabetes-related complications, improved healthcare access, and awareness programs. Public health initiatives, health education campaigns, early detection, and affordable healthcare are also crucial in reducing amputation rates. Specific interventions for diabetic foot care, timely surgical intervention, and preserving limb length and function are important considerations. CONCLUSION: Multifaceted strategies are necessary for the effective management and prevention of lower limb amputation.

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Section: Establishingmentioning

confidence: 99%

Understanding Lower Limb Amputation: A Review of the Strategies for Healthcare Improvement, Prevention, and Management

Okesina,

Nsubuga,

Omoola

et al. 2024

rmj

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Shared decision making in patients with an abdominal aortic aneurysm or peripheral artery disease: a scoping review

Kooijman,

van Leeuwen,

Schuurmann

et al. 2024

Annals of Vascular Surgery

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Optimizing Lower Extremity Amputation Outcomes: The Impact of Multidisciplinary Consultations on Revision Rates in Non-Traumatic Lower Extremity Amputations

Davulcu,

Afacan

2024

Acibadem Univ Saglik Bilim Derg

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Background/Purpose: Amputation is not merely a limb-saving surgery; it can also impose a significant burden on the healthcare system due to psychological issues and the need for prolonged, recurrent hospitalizations. Revision surgeries following lower extremity amputations continue to occur at high rates. Our study aims to identify the factors leading to revision after non-traumatic lower extremity amputations and determine whether the level of the initial amputation was accurately determined by examining the correlation between these revisions and recommendations from multidisciplinary consultations (MDC). Methods: This retrospective study included diabetic foot patients undergoing below-knee amputations between 2016 and 2021. Two groups were formed: the revision group (35 patients transitioning from transtibial to transfemoral amputation) and the control group (35 patients with initial amputations). Gender, etiology, amputation levels, time to revision, follow-up, vascular status, and multidisciplinary consultations were analyzed. The MDC team for determining the amputation levels involved orthopedics, cardiovascular surgery, plastic surgery, and infectious diseases. Each patient's adherence to the MDC recommendation level was analyzed. Results: The average follow-up time was 4.84 years. Amputation level, revision/control group status, and variables such as year, age group, and gender were independent of each other. All amputations in the revision group (100%, n=35) were transtibial. In the control group, 20% (n=7) were at the transfemoral level and 80% (n=28) were at the transtibial level. MDC recommended transfemoral amputation (TFA) to 80% (n=28) and transtibial amputation (TTA) to 20% (n=7) of participants in the revision group. MDC recommended TFA to 20% (n=7) and TTA to 80% (n=28) of participants in the control group. Of the total sample, 60% (n=42) underwent surgery aligning with MDC guidelines, while 40% (n=28) underwent procedures deviating from the recommended level. All patients (n=28, 100%) not adhering to MDC recommendations underwent revision. Conversely, among those adhering to recommendations, 83.3% (n=35) did not require revision, while only 16.7% (n=7) required it, showcasing a significant decrease in revision need when adhering to MDC recommendations (p

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Comparing Patient and Provider Priorities Around Amputation Level Outcomes Using Multiple Criteria Decision Analysis

Cited by 3 publications

References 28 publications

Understanding Lower Limb Amputation: A Review of the Strategies for Healthcare Improvement, Prevention, and Management

Understanding Lower Limb Amputation: A Review of the Strategies for Healthcare Improvement, Prevention, and Management

Shared decision making in patients with an abdominal aortic aneurysm or peripheral artery disease: a scoping review

Optimizing Lower Extremity Amputation Outcomes: The Impact of Multidisciplinary Consultations on Revision Rates in Non-Traumatic Lower Extremity Amputations

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