title: Trends in the incidence of lower extremity amputations in people with and without diabetes over a five-year period in the Republic of Ireland.
abstract: OBJECTIVE
  To describe trends in the incidence of non-traumatic amputations among people with and without diabetes and estimate the relative risk of an individual with diabetes undergoing a lower extremity amputation compared to an individual without diabetes in the Republic of Ireland.
  
  
  METHODS
  All adults who underwent a nontraumatic amputation during 2005 to 2009 were identified using HIPE (Hospital In-patient Enquiry) data. Participants were classified as having diabetes or not having diabetes. Incidence rates were calculated using the number of discharges for diabetes and non-diabetes related lower extremity amputations as the numerator and estimates of the resident population with and without diabetes as the denominator. Age-adjusted incidence rates were used for trend analysis.
  
  
  RESULTS
  Total diabetes-related amputation rates increased non-significantly during the study period; 144.2 in 2005 to 175.7 in 2009 per 100,000 people with diabetes (p = 0.11). Total non-diabetes related amputation rates dropped non-significantly from 12.0 in 2005 to 9.2 in 2009 per 100,000 people without diabetes (p = 0.16). An individual with diabetes was 22.3 (95% CI 19.1-26.1) times more likely to undergo a nontraumatic amputation than an individual without diabetes in 2005 and this did not change significantly by 2009.
  
  
  CONCLUSIONS
  This study provides the first national estimate of lower extremity amputation rates in the Republic of Ireland. Diabetes-related amputation rates have remained steady despite an increase in people with diabetes. These estimates provide a base-line and will allow follow-up over time.
authors.affiliation: Department of General Practice, University College Cork, Cork, Ireland. Claire.buckley@ucc.ie
authors.forename: Claire M
authors.initials: CM
authors.lastname: Buckley
authors.forename: Anne
authors.initials: A
authors.lastname: O'Farrell
authors.forename: Ronan J
authors.initials: RJ
authors.lastname: Canavan
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Lynch
authors.forename: Davida V
authors.initials: DV
authors.lastname: De La Harpe
authors.forename: Colin P
authors.initials: CP
authors.lastname: Bradley
authors.forename: Ivan J
authors.initials: IJ
authors.lastname: Perry
mesh_terms: D000671:Amputation, Surgical / Q000706:statistics & numerical data / Q000639:trends*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D017719:Diabetic Foot / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D007866:Leg / Q000601:surgery*; D007902:Length of Stay; D010351:Patient Discharge / Q000706:statistics & numerical data; D012306:Risk