PERCEIVE: PrEdiction of Risk and Communication of outcomE followIng major lower limb amputation- a collaboratiVE study

Having a leg amputation is a high-risk life changing event and deciding whether to have an amputation or not can be extremely difficult. For patients with extensive foot wounds and/or pain (due to diabetes or artery blockages), this may involve balancing up the risks and benefits of surgery with continuing as they are.

If very elderly patients develop leg problems which are only treatable by amputation, patients (and relatives/carers) face a difficult decision of surgery versus management of symptoms.

Making the right decision at the right time is crucial. The wrong decision can result in a reduced quality of life, patient and/or family regret, increased NHS costs and reduced engagement in rehabilitation.

In many areas of medicine, such as cancer treatment, tools are used to determine patient prognosis, risks of surgery, and probable outcomes, which is crucial in successful shared decision-making. Amputation surgery is almost completely lacking these aspects, and as a result, there are marked differences in amputation practice across Wales (and the UK).

This work will look in detail at amputation risk perception, communication and decision-making, both from a patient/family and a surgeon/clinician point of view. At the centre of PERCEIVE is the patient asking, “what is likely to happen to me if I have (or don’t have) my amputation?”.