Evidence map›Paper›PMID 40320210›Full record

ArticleAnnals of vascular surgery2025

Benefits of an Enhanced Recovery Pathway for Lower Extremity Amputation Patients.

Angela D Sickels, Clara Hua, Kory Dees, C Adam Banks, Zdenek Novak, Conley Carr, Courtney Busby, Adam W Beck, Emily L Spangler

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of vascular surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Angela D SickelsDivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
Clara HuaDivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
Kory DeesDivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
C Adam BanksDivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
Zdenek NovakDivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
Conley CarrDivision of Physical Medicine and Rehabilitation, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
Courtney BusbyDivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
Adam W BeckDivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
Emily L SpanglerDivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL. Electronic address: espangler@uabmc.edu.

Funding

MECHANISMS OF HYPERTENSION AND CARDIOVASCULAR DISEASEST32HL007457 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Martin E Young · 1985 to 2026
$8.6M
NHLBI NIH HHS T32 HL007457
6 · The paper itself

Abstract

backgroundEnhanced recovery programs (ERPs) may improve lower extremity amputation (LEA) care through interdisciplinary collaboration, patient education, multimodal pain control, and early mobilization. We sought to determine the ERP impact on outcomes for patients undergoing major LEA.

methodsPatients receiving ERP care (02/01/2022-07/31/2023) were compared to a historic pre-ERP cohort (01/01/2020-01/31/2022). Outcomes analyzed included length of stay (LOS), perioperative complications, time to prosthetic receipt, and achieved K-level.

results220 and 152 patients were in the pre-ERP and ERP groups, respectively. In the pre-ERP group, the most common indication was infection (45.0% vs. 25.2%), while in the ERP group, rest pain was most common (37.1% vs. 10.5%), P < 0.001. Staged (i.e., initial amputation followed by closure at a subsequent operation) ERP patients had lower rates of 30-day readmissions (11.9% vs. 29.3%, P = 0.01) and 90-day complications (49.3% vs. 68.0%, P = 0.02) than staged non-ERP patients. ERP below-knee amputation (BKA) patients had lower 90-day mortality than pre-ERP patients (2.5% vs. 12.2%, P = 0.02). ERP above-knee amputation (AKA) patients had a shorter LOS than pre-ERP patients (6 vs. 7 days, P = 0.04). The ERP cohort had shorter prosthetic receipt times (176 vs. 226 days, log-rank P = 0.02). Patients who achieved at least a K1 level of ambulation had greater 18-month survival compared to patients who never ambulated (log-rank P < 0.001).

conclusionERP implementation was associated with fewer complications and readmissions, most pronounced in ERP-staged patients. ERP patients tended to receive a prosthesis more quickly, which is important given the association of ambulation with survival. Significant comorbidities in this patient population highlight the importance of optimization efforts promoted by the ERP.

Indexed as

Amputation, SurgicalEnhanced Recovery After SurgeryLower ExtremityPeripheral Arterial DiseaseAgedArtificial LimbsEarly AmbulationFemaleHumansLength of StayMaleMiddle AgedPatient ReadmissionPostoperative ComplicationsRecovery of FunctionRetrospective Studies

Identifiers

PMID40320210
PMCPMC12261359

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.