title: Epidemiology of lower-extremity amputations in the Indian Health Service, 1982-1987.
abstract: OBJECTIVE
  To describe the LEA experience among IHS diabetic patients.
  
  
  METHODS
  A cross-sectional study of hospital discharges for nontraumatic LEAs from 1982 to 1987 in four IHS areas was conducted.
  
  
  RESULTS
  Incidence rates of first LEA in the study period increased with increasing age. Compared with nondiabetic subjects, diabetic patients had increased risks in each age-group, with those between the ages of 15 and 44 yr having a 158-fold increased risk. The average annual age-adjusted incidence rates of all LEAs among diabetic subjects in the Tucson (240.8/10,000) and Phoenix (203.1/10,000) IHS areas were substantially higher than the rates for the U.S. (73.1/10,000), Navajo (74.0/10,000), and the Oklahoma (87.3/10,000) IHS areas.
  
  
  CONCLUSIONS
  LEA rates varied in different IHS areas. Reasons for these findings need to be evaluated, but may include IHS area differences in preventive health-care practices or risk factors for LEA.
authors.affiliation: Indian Health Service Diabetes Program, Albuquerque, NM 87102.
authors.forename: S E
authors.initials: SE
authors.lastname: Valway
authors.forename: R W
authors.initials: RW
authors.lastname: Linkins
authors.forename: D M
authors.initials: DM
authors.lastname: Gohdes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001130:Arizona / Q000453:epidemiology; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007198:Indians, North American; D007866:Leg; D008297:Male; D008875:Middle Aged; D009825:Oklahoma; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D016549:United States Indian Health Service