OUTPATIENT FOOT CARE - CORRELATION TO AMPUTATION LEVEL

A retrospective analysis of Department of Veterans Affairs automated i npatient and outpatient records was performed for 3945 patients who un derwent lower extremity amputation surgery due to peripheral vascular disease during fiscal year 1991. Demographic and clinical data were co llected from reviewing patient database information for all Department of Veterans Affairs Hospitals nationwide. Patients were identified fr om the Physicians' Current Procedural Terminology codes for lower extr emity amputations, and then divided into three groups (above the knee, below the knee, and foot and ankle) based on the most proximal level of amputation performed. Results indicate that increased use of design ated foot care clinics was significantly associated with more distal l evel amputation surgery. Patients with above-the-knee amputations aver aged 1.0 foot care clinic visit in the 2 years prior to amputation, wh ereas below-the-knee and foot and ankle amputees averaged 2.8 and 5.3 foot care clinic visits, respectively (F[df=2,3939] = 94.20, P < .05). The same finding was noted when only users of foot care clinics were examined. Patients with a codiagnosis of diabetes were more likely to undergo distal amputation than those with other diagnoses (P < .05). T he results of this study suggest the potential effectiveness of design ated foot care clinics in preserving limb length in individuals with p eripheral vascular disease and diabetes.