Limb amputation and limb deficiency: epidemiology and recent trends in the United States.
BACKGROUND
The purpose of this study was to provide a comprehensive perspective on the epidemiology and time trends in the incidence of limb amputations and limb deficiency in the United States.


METHODS
Data from the Healthcare Cost and Utilization Project from 1988 through 1996 were used to calculate rates of congenital deficiency, trauma-related, cancer-related, and dysvascular amputations in the United States. Trends over time in adjusted rates were then examined using linear regression techniques.


RESULTS
Dysvascular amputations accounted for 82% of limb loss discharges and increased over the period studied. Over all years, the estimated increase in the rate of dysvascular amputations was 27%. Rates of trauma-related and cancer-related amputations both declined by approximately half. The incidence of congenital deficiencies remained stable.


CONCLUSIONS
The risk of amputations increased with age for all causes and was highest among blacks having dysvascular amputations. Increasing risk of dysvascular amputations, particularly among elderly and minority populations, is of concern and warrants further investigation.
Dillingham
Timothy R
TR
Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Pezzin
Liliana E
LE
MacKenzie
Ellen J
EJ
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data* / Q000639:trends*; D000673:Amputation, Traumatic / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017880:Limb Deformities, Congenital / Q000453:epidemiology* / Q000209:etiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology