Analysis of orthopedic surgery referral patterns by demographic factors in patients diagnosed with severe peripheral arterial disease in terms of partial or total limb amputation


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Cureus. 2022 Jan 20;14(1):e21455. doi: 10.7759/cureus.21455. eCollection 2022 Jan.


INTRODUCTION: Peripheral arterial disease (PAD) means the blockage of blood vessels in the lower extremities due to the harmful accumulation of fat. Patients may visit their primary care provider with complaints of lower extremity pain, especially during exercise. Primary care providers should weigh the severity of patients’ disease process to determine if referral to orthopedic surgery is needed based on a long history as well as analysis of demographic factors that may influence their risk of morbidity and of mortality. We sought to present these demographic factors objectively with numerical values ​​in terms of influence.

METHODS: We used the Cerner Health Facts database to analyze 63 million unique patient encounters from 2000 to 2018. The database is classified as exempt by the Institutional Review Board (IRB) due to its anonymized presentation . In an outcome-based approach, we were able to calculate referral patterns based on the demographic parameters entered.

RESULTS: Patient age, census region, marital status, history of MAP/critical limb ischemia (CLI), history of surgical procedures, race, facility type, and urban status /rural are shown to be predictors of seeing a surgeon during a patient encounter.

CONCLUSION: Our results revealed that many of the aforementioned demographic factors were associated with patterns of referral to orthopedic surgery. This is important because a good reconciliation of these factors can help reduce patient morbidity in terms of amputation reduction and reduce patient mortality associated with this surgery or its complications.

PMID:35223239 | CPM:PMC8860701 | DO I:10.7759/cureus.21455


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