{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T02:53:12Z","timestamp":1790304792930,"version":"4.1.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2018,4,25]],"date-time":"2018-04-25T00:00:00Z","timestamp":1524614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,7,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to estimate separate risks of major lower limb amputation and death following revascularization for peripheral artery disease (PAD) using competing risks analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Routinely collected data from Hospital Episode Statistics (HES) were used to identify patients who underwent endovascular or open lower limb revascularization for PAD in England from 2005 to 2015. The primary outcomes were major lower limb amputation and death within 5 years of revascularization. Cox proportional hazards and Fine\u2013Gray competing risks regression were used to examine the competing risks of these outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Some 164 845 patients underwent their first lower limb revascularization for PAD during the study interval. Most were men (64\u00b76 per cent) and the median age was 71 (i.q.r. 62\u201378) years. Following endovascular revascularization, the 5-year cumulative incidence of amputation was 4\u00b72 per cent in patients with intermittent claudication and 18\u00b70 per cent in those with a record of tissue loss. The corresponding rates were 10\u00b78 and 25\u00b73 per cent respectively after open revascularization, and 8\u00b71 and 25\u00b70 per cent after combined procedures. The 5-year cumulative incidence of death varied from 24\u00b75 to 39\u00b78 per cent, depending on procedure type. Competing risks methods consistently produced lower estimates than standard methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The 5-year risk of major amputation following lower limb revascularization for PAD appears lower than estimated previously. Patients undergoing revascularization for tissue loss and those who require an open procedure are at highest risk of limb loss.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.10823","type":"journal-article","created":{"date-parts":[[2018,4,25]],"date-time":"2018-04-25T08:36:46Z","timestamp":1524645406000},"page":"1145-1154","source":"Crossref","is-referenced-by-count":21,"title":["Population-based study of mortality and major amputation following lower limb revascularization"],"prefix":"10.1093","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6269-6881","authenticated-orcid":false,"given":"K","family":"Heikkila","sequence":"first","affiliation":[{"name":"Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK"},{"name":"Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I M","family":"Loftus","sequence":"additional","affiliation":[{"name":"St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D C","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Southmead Hospital, North Bristol NHS Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A S","family":"Johal","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Waton","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D A","family":"Cromwell","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK"},{"name":"Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,4,25]]},"reference":[{"key":"2021020616585508600_bjs10823-bib-0001","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1016\/S0140-6736(13)61249-0","article-title":"Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis","volume":"382","author":"Fowkes","year":"2013","journal-title":"Lancet"},{"key":"2021020616585508600_bjs10823-bib-0002","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1016\/S0140-6736(05)67704-5","article-title":"BASIL trial participants. 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