On average, 507 people lose a limb every day in the United States, and this number is expected to almost double by 2050, according to the Amputee Coalition of America (ACA). On April 16-18, the ACA’s Limb Loss Task Force met in Washington DC to develop a series of recommendations that the group hopes will serve as the roadmap to limb-loss prevention and improved care for amputees across the country.
According to ACA, the task force reviewed in-depth facts and figures that demonstrate the urgency for a strategic approach to limb-loss prevention and improved amputee care, including the following:
- 185,000 amputations occur in the United States each year.
- 60 percent of all amputations are preventable.
- Diabetes and vascular disease are the leading causes of limb loss and major drivers of increased limb-loss incidence in the United States.
- Leg amputations alone account for more than $250 million each year in healthcare costs.
- 75 percent of acquired pediatric amputations are from trauma-most notable is that, on average, 600 children per year lose a limb due to a lawnmower accident.
- Minorities are at higher risk for limb loss-African Americans are four times more likely to lose a lower limb than Caucasians of similar age and gender.
- As you age, your risk increases for limb loss, especially if you are an African American over the age of 35.
- Amputee care is not consistent nationwide. Studies show inpatient rehabilitation care following amputation significantly reduces re-amputation and mortality, but not all healthcare systems include inpatient rehab care for amputees.
“No comprehensive or integrated plan exists on the national or state level that reflects amputee care within the civilian population-no mechanism for limb loss prevention advancement, cost reduction, or care improvement for people affected by limb loss,” said Kendra Calhoun, ACA president and CEO. “In convening this expert task force, our board of directors is taking initiative to create a plan that will have a powerful impact on resolving these issues in the next decade.”
Four-Point Action Plan
The task force, consisting of experts in limb loss-physicians, podiatrists, nurses, physical therapists, prosthetists, health behavior experts, and researchers from the private and public sectors, the military, and the federal government-recommended the following four-point action plan:
- Implement a blueprint for limb-loss prevention.
- Host a consensus conference to define national optimal-care guidelines for amputees.
- Develop a national research agenda on limb-loss prevention and amputation care.
- Create a model for amputee rehabilitation/community reintegration and early limb-loss prevention to be implemented in hospitals and clinics around the country.
“We applaud the task force’s decision to support a comprehensive four-point plan,” said Terrence P. Sheehan, MD, Amputee Coalition of America’s medical director and the chief medical officer of the Adventist Rehab Hospital of Maryland. “This is the right direction, and we are confident the support of the task force combined with our organization’s execution of the four-point plan will provide a powerful impact in the fight against limb loss and the pursuit of improved amputee care. Keeping Americans healthy and living to their full potential are our primary goals.” Sheehan cited key early intervention strategies to be included in the national discussions about diabetes, obesity, and smoking cessation across the life span from teens to elders.
Raising Public Awareness
“We need people to understand that limb loss can happen to them,” Sheehan said. “Having limb loss included with stroke and heart disease as a consequence of smoking and obesity is key in raising public awareness, and including this risk in care pathways for people with diabetes and peripheral arterial disease is crucial.” The Limb Loss Task Force also stressed the importance of more research on limb-loss prevention and on living with limb loss.
“The current incidence numbers are alarming, especially for the most vulnerable, our minority populations (African Americans, Hispanic/Latino Americans, American Indians), in the United States caught in this healthcare disparity,” Sheehan wrote in a press release. “We can no longer take a passive role to implementing a successful “team approach” to support the amputee patient and the patient’s family. A major topic of the task force’s discussion was the inclusion of the amputee’s family on the care team. We see the positive outcomes with our military combat amputees and those amputees whose care systems include family members, but we need to make this approach the norm, not the exception.” The Limb Loss Task Force recommendations will be forwarded to the ACA’s board of directors for discussion at its June meeting.