Management cost of acute limb ischaemia

The cost of attempting limb salvage in patients who presented with acute lower limb ischaemia was recorded prospectively for 20 months. Seventy-five patients were admitted during the study ; 45 were treated primarily by radiological intervention and 18 had primary surgery. The remainder were treated conservatively. Patients who had primary surgery required fewer visits to the operating theatre than those who had primary thrombolysis, but there was no difference in the total time that the theatre or radiology suite was occupied : median 2.3 (10th centile range 1.5-5.0) and 3.0 (2.0-5.0) h respectively. Median (range) cost of disposables for performing surgery was £82 (58-169) and for thrombolysis was £407 (252-596). When the costs of using the theatre or radiology suite were included, the costs of both treatments were similar : surgery £683 (309-1438) and lysis £861 (611-1244). Median (10th centile range) inpatient stay for surgical patients was 9 (3-18) days and for those having thrombolysis 11 (2-29) days. Median (10th centile range) costs for bed occupancy were similar in both groups : surgery £2497 (643-9115) and lysis £2189 (902-6020). Mean cost for attempting limb salvage by surgery was £3429 (1094-10 065) compared with £3230 (1543-8353) for thrombolysis.