Trends in lower limb amputation in the Veterans Health Administration, 1989-1998

J Rehabil Res Dev. 2000 Jan-Feb;37(1):23-30.


Objective: To assess trends in lower limb amputation performed in Veterans Health Administration (VHA) facilities.

Methods: All lower limb amputations recorded in the Patient Treatment File for 1989-1998 were analyzed using the hospital discharge as the unit of analysis. Age-specific rates were calculated using the VHA user-population as the denominator. Frequency tables and linear, logistic, and Poisson regression were used respectively to assess trends in amputation numbers, reoperation rates, and age-specific amputation rates.

Results: Between 1989-1998, there were 60,324 discharges with amputation in VHA facilities. Over 99.9% of these were in men and constitute 10 percent of all US male amputations. The major indications were diabetes (62.9%) and peripheral vascular disease alone (23.6%). The age-specific rates of major amputation in the VHA are higher than US rates of major amputation. VHA rates of major and minor amputation declined an average of 5% each year, while the number of diabetes-associated amputations remained the same.

Conclusion: The number and age-specific rates of amputations decreased over 10 years despite an increase in the number of veterans using VHA care.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical / methods
  • Amputation, Surgical / statistics & numerical data
  • Amputation, Surgical / trends*
  • Diabetes Mellitus / epidemiology
  • Hospitals, Veterans / statistics & numerical data*
  • Humans
  • Incidence
  • Leg / surgery*
  • Male
  • Middle Aged
  • Registries
  • Risk Factors
  • Veterans*