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


METHODS
Retrospective study.


METHODS
One university and five county hospitals, Finland.


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


METHODS
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).


CONCLUSIONS
An active referral policy leads to reduced amputation rates.
Heikkinen
Maarit A
MA
Department of Surgery, University Hospital, Medical School, Tampere, Finland. mheik@netti.fi
Salenius
Juha P
JP
Saarinen
Jukka P
JP
Laurikka
Jari
J
Metsänoja
Riina
R
Zeitlin
Rainer
R
Suominen
Velipekka
V
Auvinen
Ossi
O
D000553:Ambulatory Care / Q000706:statistics & numerical data*; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D016507:Cardiology Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D035002:Lower Extremity; D008297:Male; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D011336:Probability; D011379:Prognosis; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012424:Rural Population; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014505:Urban Population; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data*