Lower-limb revascularization and major amputation rates in England

Background: The aim was to establish national data for lower-limb revascularization and major amputation procedures performed in England. Methods: Data for lower-limb revascularization procedures and major amputations were collected from the Hospital Episode Statistics (finished consultant episodes) which is published yearly by the Department of Health. Transluminal procedures were analysed from 1998 onwards. Age adjustment was performed according to figures for the resident population of England in the interval studied. Results: In all age groups, revascularization rates initially increased to a peak in the mid-1990s. This was followed by a steady decline in procedures to the present day. However, amputations gradually increased in the 45-64-years age group and showed only a slight decline in the 65-74-years age group. Among patients aged over 75 years there was a marked decline from the mid-1990s to present-day. Data for diabetics showed similar trends. Conclusion: The national rate of amputation initially rose despite an increasing number of vascular interventions. It is significant, however, that among patients aged over 75 years this has been followed by a decrease in both revascularization procedures and amputation rates to present levels, the lowest for 14 years.