Veterans Hospitals vs Non-Veterans Centers in the Prevention of Limb Loss

What is the incidence of major amputation among veterans with diabetes and peripheral arterial disease (PAD) after prior minor amputation, and how does this compare between Veterans Affairs (VA) vs civilian hospitals?In this cohort study of 62 295 veterans with diabetes and PAD who were not receiving dialysis, 197 major amputations occurred within 5 years after minor amputation over 3688 patient-years of follow-up. Rates of major amputation, foot care procedures, vascular imaging studies, and hemoglobin A testing were comparable to a similarly comorbid cohort of 10 654 729 Medicare beneficiaries.The findings indicate comparable limb salvage outcomes between the VA health care system and non-VA centers.

Corresponding Author: Aravind S. Ponukumati, MD, Section of Vascular Surgery, 3V, Dartmouth-Hitchcock Medical Center, One Medical Center Dr, Lebanon, NH 03766 (aravind.s.ponukumati@hitchcock.org).

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