title: Re-amputation occurrence in the diabetic population in South Wales, UK.
abstract: The incidence of re-amputation following lower extremity amputations (LEA) among the diabetic patients referred to the Artificial Limb and Appliance Centers (ALAC) in South Wales, UK, was investigated. Manual and electronic data-gathering systems were used to extract the medical records of 473 people with various causes of LEA referred to the ALAC in South Wales during 2001-2003. The data included demographic information, causes of amputation and occurrence of various levels of re-amputation. Two hundred and five subjects with diabetes underwent 316 amputations, 44 were foot amputations and 272 major amputations on the ipsilateral and contra-lateral sides. Of the diabetic patients, 45.9% with single LEA underwent re-amputations with 22% incidence of contra-lateral LEA within 2 years. In comparison, 15% underwent re-amputations in the non diabetic dysvascular patients. Ipsilateral re-amputations occurred much earlier (average 21 weeks) compared with the contra-lateral amputations which took an average of 82 weeks following the first amputation. Nearly half of the diabetic patients with single LEA referred for rehabilitation underwent re-amputations within 2 years; out of which 22% of the patients underwent contra-lateral LEA. Although the progression of level of amputations does not follow a particular pattern, re-amputation on the contra-lateral side occurred almost four times later than that on the ipsilateral side.
authors.affiliation: Department of Physiotherapy, Research Centre for Clinical Kinaesiology, School of Healthcare Studies, Cardiff University, Cardiff, UK.
authors.forename: Rajani
authors.initials: R
authors.lastname: Kanade
authors.forename: Robert
authors.initials: R
authors.lastname: van Deursen
authors.forename: Jo
authors.initials: J
authors.lastname: Burton
authors.forename: Vanessa
authors.initials: V
authors.lastname: Davies
authors.forename: Keith
authors.initials: K
authors.lastname: Harding
authors.forename: Patricia
authors.initials: P
authors.lastname: Price
mesh_terms: D017677:Age Distribution; D000671:Amputation, Surgical / Q000379:methods / Q000706:statistics & numerical data*; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D017719:Diabetic Foot / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011336:Probability; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D006113:United Kingdom / Q000453:epidemiology; D014945:Wound Healing / Q000502:physiology