AMPUTATION RATES AS A MEASURE OF VASCULAR SURGICAL RESULTS

Reconstructive surgery for critical leg ischaemia (CLI) increased in b oth hospital- and population-based patient samples over 12 years. In t he referral centre amputation numbers were unchanged over this period, although amputation carried out for patients with CLI decreased from 58 to 35 per cent. In the population sample amputation numbers decreas ed by 25 per cent and amputations of patients with CLI decreased from 79 to 43 per cent. Patient characteristics and amputation patterns wer e different in the two settings. Amputation rates as a measure of the efficacy of an arterial reconstruction policy should be used only on a population basis. The analysis is skewed by selection bias in referra l centres.