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首页> 外文期刊>The international journal of lower extremity wounds >Nontraumatic amputation: Incidence and cost analysis
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Nontraumatic amputation: Incidence and cost analysis

机译：非创伤性截肢：发生率和成本分析

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Lower extremity amputation (LEA) is devastating for those affected and a significant factor in health care costs. Although the overall incidence of amputation has been declining, the decline is not universal. The objectives of this study were to identify patients with nontraumatic amputation at Harbor-UCLA Medical Center (HUMC) from January 2000 to January 2007, to calculate their 1-year and 5-year mortality rates after amputation and to estimate the financial cost of those amputations. The authors searched the HUMC electronic database by ICD codes (84.10-84.18) to identify patients with LEA and subsequently searched the National Death Index database for deaths in study subjects to calculate mortality rates. HUMC is a Los Angeles County tertiary teaching medical center that provides medical care to a large percentage of the Los Angeles County population, especially those without health insurance. There were 1169 admissions in 847 patients with nontraumatic LEA with a 1-year mortality rate of 9.1% and 5-year mortality rate of 25.6%. Only major amputation and increasing age were independent risk factors for 1-year mortality rate. At 1 year, the re-amputation rate for nontraumatic LEA was 26.7%. African American and Hispanic females had a significantly higher percentage of major amputations than corresponding males and white females. The average length of hospital stay was more than double for patients with nontraumatic amputation than for all other admissions (12.7 vs 5.3 days). There were 14 846 hospital days for 1169 nontraumatic amputation admissions with an estimated cost of $47 033 767. Amputation remains common at HUMC and the associated mortality rates and economic costs are high. In the authors' opinion, a coordinated and serious campaign by all involved in the health care system is urgently needed to implement proven and effective measures such as establishing multidisciplinary foot care clinics to reduce amputation.
机译：下肢截肢术（LEA）对于那些受影响的人来说是毁灭性的，并且是医疗保健成本的重要因素。尽管截肢的总发生率一直在下降，但下降并非普遍。本研究的目的是确定2000年1月至2007年1月在Harbour-UCLA医疗中心（HUMC）进行非创伤性截肢的患者，计算截肢后的1年和5年死亡率，并估算这些患者的财务费用截肢。作者通过ICD代码（84.10-84.18）在HUMC电子数据库中进行搜索，以识别LEA患者，随后在国家死亡指数数据库中搜索了研究对象的死亡率，以计算死亡率。 HUMC是洛杉矶县的三级教学医疗中心，可为洛杉矶县的大部分人口提供医疗服务，尤其是那些没有医疗保险的人。 847例非创伤性LEA患者共入院1169例，其中1年死亡率为9.1％，5年死亡率为25.6％。仅大截肢和年龄增长是1年死亡率的独立危险因素。在1年时，非创伤性LEA的重新定植率为26.7％。非洲裔美国人和西班牙裔女性的主要截肢百分比明显高于相应的男性和白人女性。非创伤性截肢患者的平均住院时间是所有其他住院时间的两倍以上（12.7 vs 5.3天）。 1169例非创伤性截肢手术共住院14 846天，估计费用为47 033 767美元。HUMC截肢仍然很普遍，相关的死亡率和经济成本很高。作者认为，迫切需要所有参与医疗保健系统的人开展协调认真的运动，以实施行之有效的措施，例如建立多学科的足部护理诊所以减少截肢。

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