Toomey Anne Marie, Leahy Fiona, Purtill Helen, O'Brien Norma, O'Donovan Emer, Ahmed Zeeshan, Medani Mekki, Moloney Tony, Kavanagh Eamon G
School of Medicine, University of Limerick, Co. Limerick, V94 T9PX, Limerick, Ireland.
Department of Vascular Surgery, University Hospital Limerick, St Nessan's Rd, V94 F858, Dooradoyle Co. Limerick, Ireland.
Ir J Med Sci. 2025 Apr;194(2):663-673. doi: 10.1007/s11845-025-03885-9. Epub 2025 Feb 6.
The prevalence of peripheral arterial disease (PAD) is increasing globally. An increase in PAD in an ageing population inevitably results in an increase in incidence of Chronic Limb Threatening Ischemia (CLTI). Loss of a limb is a life-changing event with immeasurable cost to the individual, while the potential financial benefit of saving a limb is not well documented.
The focus of this study was to estimate the cost associated with surgical interventions used in the treatment of CLTI compared with amputation.
The cost to treat a CLTI diagnosis in 124 patients was analysed in an acute tertiary referral hospital over a 13-month study period. The analysis included staffing, medical devices used, number of blood components used and the length of stay. Statistical methods included descriptive statistical data and the Mann-Whitney U test.
The median cost, associated with length of stay, post-amputation and post-revascularisation (hybrid) was €61,313 [IQR = €44,417, €83,331] and €46,573 [IQR = €25,687, €58,554] respectively, p < 0.001. The total median cost for length of stay for amputees in an acute hospital, rehabilitation and a prosthetic limb was €88,820 [IQR = €74,486, €110,248]. The median surgical cost of an amputation was €2,064 [IQR = €1,342, €2,866], whilst the median surgical cost of a revascularisation procedure (hybrid) was €5,966 [IQR = €4,380, €7,723], p < 0.001, inclusive of total blood components transfused.
Revascularisation surgical interventions are more expensive than amputation, however, the length of stay, rehabilitation and prosthetic limb costs, for a patient undergoing a major limb amputation, is significantly more costly.
全球外周动脉疾病（PAD）的患病率正在上升。老年人群中PAD的增加不可避免地导致慢性肢体威胁性缺血（CLTI）发病率的上升。肢体缺失是一个改变人生的事件，对个人造成的代价无法估量，而挽救肢体的潜在经济益处却没有充分的文献记载。
本研究的重点是估计与治疗CLTI的手术干预措施相比截肢的相关成本。
在一家急性三级转诊医院进行了为期13个月的研究，分析了124例CLTI诊断患者的治疗成本。分析内容包括人员配备、使用的医疗设备、使用的血液成分数量和住院时间。统计方法包括描述性统计数据和曼-惠特尼U检验。
与住院时间、截肢后和血管重建（杂交手术）相关的中位数成本分别为61,313欧元[四分位距=4,4417欧元，83,331欧元]和46,573欧元[四分位距=25,687欧元，58,554欧元]，p<0.001。急性医院中截肢患者的住院、康复和假肢的总中位数成本为88,820欧元[四分位距=74,486欧元，110,248欧元]。截肢的中位数手术成本为2,064欧元[四分位距=1,342欧元，2,866欧元]，而血管重建手术（杂交手术）的中位数手术成本为5,966欧元[四分位距=4,380欧元，7,723欧元]，p<0.001，包括输注的全血成分。
血管重建手术干预比截肢更昂贵，然而，对于接受大肢体截肢的患者，住院时间、康复和假肢成本要高得多。
