# Analyzing attempt and success factors for amputated digit replantation in Japan using the diagnosis procedure combination database

## TL;DR

This study analyzed factors affecting finger replantation attempts and success rates in Japan using a national database.

## Contribution

The study provides insights into replantation practices and success factors in Japan, where prior data was lacking.

## Key findings

- Replantation was more frequent for thumbs and performed during overtime hours, Sundays, and in educational institutions.
- Success rates were higher for thumb replantations and patients under 20 years old.
- Patients over 65 treated with urokinase had higher failure rates, independent of hospital or regional factors.

## Abstract

The number of amputated finger replantation has declined in the USA and Germany in recent years; however, there have been no reports on recent trends in Japan. We examined the current practices, attempts, and success factors of digit replantation in Japan. We hypothesized that the rates of digit replantation and success rates were consistently standardized in Japan. The diagnosis procedure combination database was used to analyze 14004 cases from April 2014 to March 2020, excluding multiple-digit amputations, thus focusing on 13484 patients. We evaluated replantation success rates and identified factors influencing replantation decisions using multiple logistic regression analysis. The key findings included a higher frequency of replantation in thumb cases and surgeries during overtime hours, on Sundays, and in educational institutions. Success rates were notably higher for thumb replantations and patients under 20 years of age. Patients over 65 years of age treated with urokinase showed higher failure rates, unrelated to regional or hospital case volumes. The number of amputated digit replantation surgeries in Japan was high during overtime hours, on Sundays, and in educational institutions. Region, hospital type, and hospital case volume were not associated with a low success rate across Japan.