{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T02:07:40Z","timestamp":1785377260916,"version":"3.55.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"5","funder":[{"DOI":"10.13039\/100001316","name":"Abbott","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001316","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Missed opportunities to reduce numbers of primary major lower-limb amputation and increase limb-salvage procedures when treating chronic limb-threatening ischaemia have previously been identified in the literature. However, the potential economic savings for healthcare providers when salvaging a chronic limb-threatening ischaemia-affected limb have not been well documented.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A model using National Health Service healthcare usage and cost data for 1.6 million individuals and averaged numbers of primary surgical procedures for chronic limb-threatening ischaemia from England and Wales in 2019\u20132021 was created to perform a budget impact analysis. Two scenarios were tested: the averaged national rates of major lower-limb amputation (above the ankle joint), angioplasty, open bypass surgery or arterial endarterectomy in the National Vascular Registry (current scenario); and revascularization rates adjusted based on the lowest amputation rate reported by the National Vascular Registry at the time of the study (hypothetical scenario). The primary outcome was the net impact on costs to the National Health Service over 12 months after the index procedure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the current scenario, the proportions of different index procedures were 10% for lower-limb major amputation, 55% for angioplasty, 25% for open bypass surgery and 10% for arterial endarterectomy. In the hypothetical scenario, the procedure rates were 3% for major lower-limb amputation, 59% for angioplasty, 27% for open bypass surgery and 11% for arterial endarterectomy. For 16 025 index chronic limb-threatening ischaemia procedures, the total care cost in the current scenario was \u20ac243 924 927. In the hypothetical scenario, costs would be reduced for index procedures (\u2212\u20ac10 013 814), community care (\u2212\u20ac633 943) and major cardiovascular events (\u2212\u20ac383 407), and increased for primary care (\u20ac59 827), outpatient appointments (\u20ac120 050) and subsequent chronic limb-threatening ischaemia-related surgery (\u20ac1 179 107). The net saving to the National Health Service would be \u20ac9 645 259.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A shift away from primary major lower-limb amputation towards revascularization could lead to substantial savings for the National Health Service without major cost increases later in the care pathway, indicating that care decisions taken in hospitals have wider benefits.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrae099","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T08:49:58Z","timestamp":1726649398000},"source":"Crossref","is-referenced-by-count":1,"title":["Economic impact of limb-salvage strategies in chronic limb-threatening ischaemia: modelling and budget impact study based on national registry data"],"prefix":"10.1093","volume":"8","author":[{"given":"Athanasios","family":"Saratzis","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences, National Institute for Health and Care Research (NIHR) Biomedical Research Centre (BRC) , Leicester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hany","family":"Zayed","sequence":"additional","affiliation":[{"name":"School of Cardiovascular Medicine and Metabolic Sciences, King\u2019s College London , London ,","place":["UK"]},{"name":"Department of Vascular Surgery, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Buylova","sequence":"additional","affiliation":[{"name":"National Health Service Health Economics Unit, NHS Midlands and Lancashire Commissioning Support Unit , Stoke on Trent ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Rawlinson","sequence":"additional","affiliation":[{"name":"National Health Service Health Economics Unit, NHS Midlands and Lancashire Commissioning Support Unit , Stoke on Trent ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giota","family":"Veliu","sequence":"additional","affiliation":[{"name":"Abbott Health Economics & Reimbursement Department , Zaventem ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Siebert","sequence":"additional","affiliation":[{"name":"Abbott Health Economics & Reimbursement Department , Zaventem ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,9,18]]},"container-title":["BJS Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/8\/5\/zrae099\/60179828\/zrae099.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/8\/5\/zrae099\/60179828\/zrae099.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T20:53:37Z","timestamp":1730235217000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjsopen\/article\/doi\/10.1093\/bjsopen\/zrae099\/7759873"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,3]]},"references-count":0,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,9,3]]}},"URL":"https:\/\/doi.org\/10.1093\/bjsopen\/zrae099","relation":{},"ISSN":["2474-9842"],"issn-type":[{"value":"2474-9842","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,10]]},"published":{"date-parts":[[2024,9,3]]},"article-number":"zrae099"}}