Regional differences in the use of a vascular surgical service and incidence of amputations in a well-defined geographical area.

Maarit A Heikkinen, Juha P Salenius, Jukka P Saarinen, Jari Laurikka, Riina Metsänoja, Rainer Zeitlin, Velipekka Suominen, Ossi Auvinen
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Abstract

Objective: To evaluate regional differences in the use of a vascular surgical service in the treatment of critical lower limb ischaemia and incidence of amputation in the 1990s in a well-defined geographical area.

Design: Retrospective study.

Setting: One university and five county hospitals, Finland.

Subjects: All referrals to the university hospital vascular surgical unit for chronic critical lower limb ischaemia and the number of major amputations in the region.

Main outcome measures: Numbers of new vascular surgical consultations and amputations in 11 municipalities. Correlation between numbers of consultations and amputations.

Results: Between the subregions the age-standardised incidence of new vascular surgical consultations in the 15-85 year old population varied from 52.4 to 104.7/10(5) and the incidence of amputation from 10.2 to 24.8/10(5). There was an inverse correlation between the numbers of consultations and amputations. The most significant inverse correlation was between consultations and below knee amputations in diabetic patients (r = -0.70). For above knee amputations there was no correlation (r = -0.21).

Conclusion: An active referral policy leads to reduced amputation rates.

在一个明确的地理区域内,血管外科服务的使用和截肢发生率的区域差异。
目的:评价20世纪90年代在一个明确的地理区域内,血管外科服务在治疗严重下肢缺血和截肢发生率方面的区域差异。设计:回顾性研究。环境:芬兰,一所大学和五所县医院。对象:所有转诊到大学医院血管外科治疗慢性重症下肢缺血的病例和本地区主要截肢病例的数量。主要观察指标:11个市新增血管外科会诊和截肢病例数。就诊次数与截肢之间的相关性。结果:各分区15-85岁人群新血管手术就诊的年龄标准化发生率为52.4 - 104.7/10(5),截肢发生率为10.2 - 24.8/10(5)。就诊次数与截肢次数呈负相关。糖尿病患者就诊与膝下截肢之间的负相关最为显著(r = -0.70)。对于膝以上截肢,无相关性(r = -0.21)。结论:积极的转诊政策可降低截肢率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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