Trends in lower extremity amputations in people with and without diabetes in England, 1996-2005.
OBJECTIVE
To examine trends in non-traumatic lower extremity amputations over a 10-year-period in people with and without diabetes (DM) in England.


METHODS
All individuals admitted to NHS hospitals for non-traumatic amputations between 1996 and 2005 in England were identified using hospital activity data. Postoperative and 1-year mortality were examined between 2000 and 2004.


RESULTS
There was a reduction in minor and major amputations during the study period. The number of type 1 DM- and non-DM-related minor amputations decreased by 11.4% and 32.4%, respectively, while the number of type 2 DM-related minor amputations almost doubled. The incidence of type 1- and non-DM-related minor amputations decreased from 1.5 to 1.2 and from 8.1 to 5.1/100,000 population, respectively, while type 2 DM-related amputations increased from 2.4 to 4.1/100,000 population. The number of type 1- and non-DM-related major amputations declined by 41% and 22%, respectively, whereas type 2 DM-related amputations increased by 43%. The incidence of type 2 DM-related amputations increased from 2.0 to 2.7/100,000 population. Overall perioperative and 1-year mortality did not significantly change between 2000 and 2004.


CONCLUSIONS
While several factors may explain the increase in type 2 DM-related LEAs, these findings highlight the importance of diabetes prevention strategies and controlling risk factors for LEAs in people with diabetes.
Vamos
Eszter Panna
EP
Department of Primary Care and Public Health, Imperial College London, UK. e.vamos@imperial.ac.uk
Bottle
Alex
A
Majeed
Azeem
A
Millett
Christopher
C
D000289:Admitting Department, Hospital / Q000706:statistics & numerical data; D000368:Aged; D000671:Amputation, Surgical / Q000401:mortality / Q000706:statistics & numerical data*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D017719:Diabetic Foot / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011203:Poverty; D012086:Reoperation / Q000706:statistics & numerical data