A Lack of Decline in Major Nontraumatic Amputations in Texas: Contemporary Trends, Risk Factor Associations, and Impact of Revascularization

Abstract

Nontraumatic major lower extremity amputations (LEAs) have been reported to be declining nationally; however, trends in Texas have been less well described. We evaluated demographic and clinical risk factors and revascularization associations for LEAs by using inpatient hospital discharge data in Texas from 2005 to 2014. RESEARCH DESIGN AND METHODS Inpatient hospital discharge data were obtained from the Texas Center for Health Statistics. Multivariate logistic regression analyses were performed to evaluate clinical, ethnic, and socioeconomic risk factors associated with LEA. The impact of revascularization (surgical and/or endovascular) on LEA was analyzed. RESULTS

Diabetes mellitus and other cardiovascular risk factors in lower-extremity peripheral artery disease versus coronary artery disease: an analysis of 1,121,359 cases from the nationwide databases

“…Clinical profiles might be different between the two revascularization procedures, although recent clinical studies have shown that major patient backgrounds are not so largely different between them in clinical practice [39, 40]. On the other hand, previous studies suggested that patient attributes would be different between LE-PAD patients undergoing revascularization and those undergoing primary amputation [41]. Future studies in other countries will be needed to validate the current findings.…”

Temporal Trends in Incidence Rates of Lower Extremity Amputation and Associated Risk Factors Among Patients Using Veterans Health Administration Services From 2008 to 2018

“…The clinical factors associated with LEA were selected based on previous studies. 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 Stages of CKD were determined using the mean level of outpatient estimated glomerular filtration rate (eGFR) in that year 40 : eGFR greater than or equal to 60 mL/min/1.73 m 2 was defined as no CKD, eGFR between 45 and 59 mL/min/1.73 m 2 was defined as CKD 3A, eGFR between 30 and 44 mL/min/1.73 m 2 was defined as CKD 3B, and eGFR between 15 and 29 mL/min/1.73 m 2 was defined as CKD 4. CKD 5 was defined as eGFR less than 15 mL/min/1.73 m 2 with no history of kidney transplantation or dialysis.…”

The case for early identification and intervention of chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

“…1 In many regions, persons with lower socioeconomic status have a higher prevalence of CKD, limited access to treatment, and poorer outcomes. [2][3][4][5] Early identification of CKD by screening for kidney disease, followed by risk stratification and treatment, offers the potential to substantially reduce the morbidity and mortality from CKD and its related complications, such as cardiovascular disease. 6,7 However, at present, there is no accepted systematic strategy for CKD screening and treatment.…”