Trends in lower extremity amputations in people with and without diabetes in England, 1996-2005

Diabetes Res Clin Pract. 2010 Feb;87(2):275-82. doi: 10.1016/j.diabres.2009.11.016.

Abstract

Aims: To examine trends in non-traumatic lower extremity amputations over a 10-year-period in people with and without diabetes (DM) in England.

Methods: All individuals admitted to NHS hospitals for non-traumatic amputations between 1996 and 2005 in England were identified using hospital activity data. Postoperative and 1-year mortality were examined between 2000 and 2004.

Results: There was a reduction in minor and major amputations during the study period. The number of type 1 DM- and non-DM-related minor amputations decreased by 11.4% and 32.4%, respectively, while the number of type 2 DM-related minor amputations almost doubled. The incidence of type 1- and non-DM-related minor amputations decreased from 1.5 to 1.2 and from 8.1 to 5.1/100,000 population, respectively, while type 2 DM-related amputations increased from 2.4 to 4.1/100,000 population. The number of type 1- and non-DM-related major amputations declined by 41% and 22%, respectively, whereas type 2 DM-related amputations increased by 43%. The incidence of type 2 DM-related amputations increased from 2.0 to 2.7/100,000 population. Overall perioperative and 1-year mortality did not significantly change between 2000 and 2004.

Conclusions: While several factors may explain the increase in type 2 DM-related LEAs, these findings highlight the importance of diabetes prevention strategies and controlling risk factors for LEAs in people with diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Admitting Department, Hospital / statistics & numerical data
  • Aged
  • Amputation / mortality
  • Amputation / statistics & numerical data*
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 2 / complications
  • Diabetic Foot / epidemiology
  • Diabetic Foot / mortality
  • Diabetic Foot / surgery*
  • England / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Postoperative Period
  • Poverty
  • Reoperation / statistics & numerical data