Canadian Journal of Cardiology

Contrasting Trends in Vascular Amputations: Progress or Peril?

  • Daniel G. Hackam
    Corresponding author: Dr Daniel G. Hackam, Room B9-116A, London Health Sciences Centre, University Hospital, 339 Windemere Road, London, Ontario N6A 5A5, Canada. Tel.: +1-519-663-3340; fax: +1-519-663-3217.
    Division of Clinical Pharmacology, Department of Medicine, Department of Epidemiology & Biostatistics, and Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
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Published:December 14, 2022DOI:
      Amputation is a dreaded complication of peripheral artery disease (PAD) and diabetes mellitus. In this issue of the Canadian Journal of Cardiology, O’Connor et al. studied secular trends in the incidence of primary lower-extremity amputations (LEAs) associated with PAD or diabetes in the province of Québec, Canada, between the years 2006 and 2019.
      • O’Connor S.
      • Blais C.
      • Leclerc J.
      • et al.
      Evolution in trends of primary lower-extremity amputations associated with diabetes or peripheral artery disease from 2006 to 2019.
      The investigators used large administrative databases linked together in the Quebec Integrated Chronic Disease Surveillance System to capture episodes of LEA, subclassifying these as major and minor, based on the highest level of amputation.
      • Blais C.
      • Jean S.
      • Sirois C.
      • et al.
      Quebec Integrated Chronic Disease Surveillance System (QICDSS), an innovative approach.
      Amputations related to trauma, cancer, infection, congenital malformation, or venous or lymphatic impairment were excluded. Altogether, just over 10,000 patients with diabetes or PAD underwent primary LEA between 2006 and 2019 (n = 10,287).
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