title: Seasonal variations in non-traumatic major lower limb amputation in Hong Kong Chinese diabetic patients.
abstract: OBJECTIVE
  To study the relationship between hospitalisation for diabetic foot complications, non-traumatic major lower limb amputations, and seasonal variation in humidity and temperature.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Regional hospital, Hong Kong.
  
  
  METHODS
  Diabetic patients hospitalised for lower limbs infection during the inclusive period 1995 to 2004.
  
  
  METHODS
  Monthly incidence of admissions for diabetic foot sepsis and non-traumatic non-neoplastic major lower limb amputations correlated with the monthly average humidity and temperature.
  
  
  RESULTS
  During the study period, a total of 770 patients contributed to 1285 episodes of hospitalisation and ensued 208 corresponding major lower limb amputations. Poisson regression study showed that the monthly incidences of hospitalisation as well as amputations were related to the monthly average temperature (P<0.001 and =0.0012, respectively) but not the monthly average humidity (P=0.1560 and 0.6332, respectively).
  
  
  CONCLUSIONS
  The warm and humid weather of Hong Kong exerts a seasonal variation on the diabetic foot infection presentations. Warm temperature aggravates the severity of infection and precipitates amputation. More intensive patient education and clustering of medical services in late winter and spring might reduce the incidence of diabetic foot amputation, which is a preventable complication.
authors.affiliation: Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Kowloon, Hong Kong. adrianleunghb@yahoo.com
authors.forename: H B
authors.initials: HB
authors.lastname: Leung
authors.forename: Y C
authors.initials: YC
authors.lastname: Ho
authors.forename: W C
authors.initials: WC
authors.lastname: Wong
authors.forename: Jeff
authors.initials: J
authors.lastname: Guerin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D002681:China / Q000208:ethnology; D017719:Diabetic Foot / Q000453:epidemiology / Q000208:ethnology / Q000601:surgery*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D006813:Humidity; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D012044:Regression Analysis; D012189:Retrospective Studies; D012621:Seasons; D018805:Sepsis / Q000209:etiology; D013696:Temperature