Callow A D, Mackey W C
Department of Surgery, Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts.
Int Surg. 1988 Oct-Dec;73(4):237-40.
For a variety of reasons, primary amputation is often advised in the elderly individual with a severely ischemic leg. Reinforcing this recommendation is the perception that reconstructive arterial surgery in this group is far more expensive than the primary amputation. Living more than only one more year after amputation, professional nursing care cost approaches $100,000. In two recent studies, the cost for patients undergoing primary below the knee amputations plus rehabilitation was almost identical to the mean patient cost for arterial reconstruction. In addition, under the prospective payment systems, substantial financial loss accrues to hospitals caring for these patients.
由于多种原因，对于患有严重缺血性腿部疾病的老年人，通常建议进行一期截肢。这一建议的依据是，人们认为该群体的重建性动脉手术比一期截肢要昂贵得多。截肢后存活超过一年，专业护理费用接近10万美元。在最近的两项研究中，接受一期膝下截肢加康复治疗的患者费用几乎与动脉重建的平均患者费用相同。此外，在前瞻性支付系统下，照顾这些患者的医院会遭受重大经济损失。
