Home > Journals > The Journal of Cardiovascular Surgery > Past Issues > The Journal of Cardiovascular Surgery 2020 August;61(4) > The Journal of Cardiovascular Surgery 2020 August;61(4):435-44



Publishing options
To subscribe
Submit an article
Recommend to your librarian


Publication history
Cite this article as



The Journal of Cardiovascular Surgery 2020 August;61(4):435-44

DOI: 10.23736/S0021-9509.19.10936-6


language: English

The burden of amputation in patients with peripheral arterial disease in the Netherlands

Jelle A. SPOORENDONK 1 , Marieke KROL 2, Cathelijne ALLEMAN 1

1 Pharmerit International, Rotterdam, the Netherlands; 2 IQVIA, Amsterdam, the Netherlands

INTRODUCTION: Peripheral arterial disease (PAD) can lead to severe cases of critical limb ischemia (CLI), which in turn might lead to amputation. Amputation can have substantial consequences for patients. This publication aims to give a better understanding of the amputation-related burden in patients with PAD in the Netherlands.
EVIDENCE ACQUISITION: A systematic review and grey literature searches were conducted followed by qualitative interviews with a multidisciplinary team of clinical experts in amputation. Subsequently, IQVIA’s Dutch hospital claims data were analyzed.
EVIDENCE SYNTHESIS: Twenty-seven publications were identified. Dutch claims data identified claims for 2328 patients after amputation for PAD. Data for the following topics were found: incidence, mortality, complications, mobility, daily functioning, quality of life, utilities, length of stay (LoS), costs, and resource use. Annually, 90% of the 3300 amputations carried out in the Netherlands were due to vascular disease. One-year mortality in patients with an amputation ranged from 49.6% (above-the-knee amputation) to 9% (specialized care). Patients’ quality of life was substantially affected and utility of post-major amputation for PAD was 0.54. LoS after amputation varied from 11.4 (general rehabilitation) to 53.4 days (amputation of the leg). Total budget incurred based on frequently claimed DBC’s from Dutch claims data in patients with PAD undergoing an amputation over 2012 to 2016 was € 136,651,374. Mean cost per patient was € 17,821.
CONCLUSIONS: Amputation leads to substantial burden in patients with PAD in the Netherlands. Identified results give a better understanding of the specific Dutch burden of amputation.

KEY WORDS: Amputation; Peripheral arterial disease; Cost of illness; Mortality; Netherlands

top of page