Lower Limb Amputations: Analysis of Hospitalizations of Patients with Lower Limb Arterial Diseases in Khabarovsk Krai. A Retrospective Study

Relevance of the problem. In the Russian Federation, about 10 thousand non-traumatic operations on the lower extremities are performed annually. According to statistics, the most common cause of amputations are vascular diseases - up to 90 % of all non- traumatic amputations are performed due to the progression of lower extremity arterial diseases (LEAD). The most common causes of LEAD are atherosclerosis and obliterating thromboangiitis. A feature of atherosclerosis, in particular, obliterating atherosclerosis of the arteries of the lower extremities, is the tendency to constant progression of the process, which within 3–5 years of the disease leads to gangrene and amputation of the limb. Objective. To analyze hospitalizations of patients with diseases of the arteries of the lower extremities and summarize proposals for identifying early hemodynamic disorders in capillary vessels to prevent the development of fatal complications leading to amputation of the lower extremities. Material and methods. A retrospective analysis of hospitalizations of patients with lower extremity arterial diseases was conducted in Khabarovsk Krai for the period from 2017 to 2023 in two age groups – of working age (men aged 16–59 years, women aged 16-54 years) and older than working age (men aged 60 years and older, women aged 55 years and older) with diagnoses I70.2 "Atherosclerosis of the arteries of the extremities" and I73.1 "Obliterating thromboangiitis" (ICD-10). The work used statistical data from the "Medical Information Analytical Center" of the Ministry of Health of Khabarovsk Krai, as well as content analysis methods of scientific publications in the eLIBRARY.RU, PubMed, Web of Science databases by keywords: atherosclerosis, obliterating thromboangiitis, hospitalization, critical ischemia, amputation. Results and discussion. The study has shown that in Khabarovsk Krai, from January 1, 2017 to December 31, 2023, a total of 4,493 amputations and disarticulations on the lower limbs were performed in patients with lower limb arterial diseases. The number of amputations and disarticulations in patients admitted both planned and emergency has a tendency to increase - from 18.2 cases per 100 thousand of the working-age population in 2017 to 23.3 in 2023, and in patients older than working age – from 29.5 cases per 100 thousand of the population in 2017 to 42.1 in 2023. In-hospital mortality for the study period in patients with LEAD increased from 3.7 % in 2017 to 4.3 % in 2023 and averaged 3.8 %, while postoperative mortality tended to increase from 8.5 % in 2017 to 9.8 % in 2023. Conclusion. The problem of lower limb amputations remains relevant today. The risk of lower limb amputations leading to loss of ability to work, disability, decreased life expectancy, as well as increased public expenditure on treatment, dictates the need to develop comprehensive measures to prevent chronic ischemia leading to imminent loss of a limb: · Conducting regular screening studies in the population to detect early symptoms of LEAD. · Creating a single register of patients with LEAD. · Ensuring a full cycle of medical care for patients with LEAD: outpatient clinic – hospital – outpatient clinic.