Diabetes-related lower extremity amputation rates fall significantly in South Carolina.
BACKGROUND
The aims of this study are to compare the diabetes-related lower extremity amputation (LEA) rate trend in South Carolina (SC) to that of the United States (US) and to determine changes in LEA rates in SC according to age, race, gender, and amputation


METHODS
National Hospital Discharge Survey (NHDS) and SC hospital discharge data for 1996 to 2002 were analyzed. ICD-9-CM codes identified all diabetic patients and occurrences of LEA. Linear regression was used to compare the LEA rate trends between SC and the US.


RESULTS
LEA rates are decreasing throughout the study period. The slope is greater in SC compared with US (US slope = -0.00082; SC slope = -0.0015; P = 0.002), signifying a decrease in LEA rates of 1.5/1000 per year in SC and 0.8/1000 per year in the US. Furthermore, LEA rate decreases in SC are significant throughout all ages, races, genders, and amputation levels.


CONCLUSIONS
Diabetes-related LEA rates are decreasing in SC more rapidly than in the US. Ongoing community-level education may be assisting in the favorable trends.
Mountford
William K
WK
Department of Biostatistics, Bioinformatics, and Epidemiology, Endocrinology, Diabetes, and Medical Genetics Division, Medical University of South Carolina, Charleston, SC, USA. mountfo@musc.edu
Soule
Jeremy B
JB
Lackland
Daniel T
DT
Lipsitz
Stuart R
SR
Colwell
John A
JA
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D017719:Diabetic Foot / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D038801:International Classification of Diseases / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D013022:South Carolina / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data