Louise Skovgaard Londero, MD Department of Cardiothoracic- and Vascular Surgery University Hospital of Odense Sdr. Boulevard 29 5000 Odense C Fighting amputations of the lower limbs (FALL) – from epidemiological risk identification to cost effective direct actions. Symptomatic peripheral arterial disease (PAD) is associated with a significant morbidity and mortality including high rates of major amputations of the lower limbs. Around 80% of all major amputations of the lower limb have the etiology of symptomatic PAD and many of these patients also have diabetes mellitus (DM). Patients with DM have a 12-24-fold higher risk of having a major amputation compared with non-diabetics as well as a lower amputation-free survival after surgery for critical limb ischemia. It has also been identified that later major amputation after primary vascular reconstruction may be associated with generic types of medication. In Denmark the incidence for major amputation is approximately 21/100.000 but with a difference between regions. The aim of this project is to identify “high risk” patients concerning modifiable end potentially upcoming risk factors (socio-economic, co-morbidity incl. DM, use of secondary medical prevention and whether the patients have received vascular evaluation/surgery prior to amputation). We will also try to identify optimal cost effective vascular reconstruction intensities to prevent major amputations in a cost effective way. The project is epidemiologically based study gathering information from different national databases. The results will be used to guide preventive actions in the Region of Southern Denmark. The effect of this action will be monitored but is beyond the scope of this study.