Epidemiology of critical limb ischaemia : north Italian data

OBJECTIVES: We confronted the difficult problem of obtaining accurate epidemiological data on critical leg ischaemia. METHODS: Three different approaches were used. 1) A prospective study, over a total period of 7 years, on the incidence of critical leg ischaemia in 200 patients suffering from claudication and in 190 controls. 2) A prospective study, over a period of 3 months, on critical leg ischaemia hospitalization in a sample of hospitals located in a Region of Northern Italy (Lombardy). 3) Encoding the amputations performed in the hospitals in two regions of Northern Italy: for 6 months in Lombardy and for 2 years in Emilia Romagna. RESULTS: The data obtained through the three different methodological approaches provided results that were substantially equivalent in order of magnitude. The incidence in the population aged > 45 years turned out to be 450/million/year for critical leg ischaemia and 112/million/year for amputations. In the sample of hospitals in Lombardy, the incidence in the population aged > 45 years was 652/million/year for critical leg ischaemia and 160/million/year for amputations. The incidence of amputations in Lombardy and Emilia Romagna in the population aged > 45 years was 577/million/year for critical leg ischaemia and 172/million/year for amputations in Lombardy and 530/million/year for critical leg ischaemia and 154/million/year for amputations in Emilia Romagna. CONCLUSION: The results indicate an incidence of critical leg ischaemia and amputations lower than expected in the samples studied. It is known that Italy is a country with one of the highest rates of "cardiovascular protection". Therefore, genetic and dietary factors probably play an important role also in the development of critical leg ischaemia and in the consequent incidence of amputations.