title: Lower limb amputation in Northern Netherlands: unchanged incidence from 1991-1992 to 2003-2004.
abstract: BACKGROUND
  Investigating population changes gives insight into effectiveness and need for prevention and rehabilitation services. Incidence rates of amputation are highly varied, making it difficult to meaningfully compare rates between studies and regions or to compare changes over time.
  
  
  METHODS
  Historical cohort study of transtibial amputation, knee disarticulation, and transfemoral amputations resulting from vascular disease or infection, with/without diabetes, in 2003-2004, in the three Northern provinces of the Netherlands.
  
  
  OBJECTIVE
  To report the incidence of first transtibial amputation, knee disarticulation, or transfemoral amputation in 2003-2004 and the characteristics of this population, and to compare these outcomes to an earlier reported cohort from 1991 to 1992.
  
  
  METHODS
  Population-based incidence rates were calculated per 100,000 person-years and compared across the two cohorts.
  
  
  RESULTS
  Incidence of amputation was 8.8 (all age groups) and 23.6 (≥45 years) per 100,000 person-years. This was unchanged from the earlier study of 1991-1992. The relative risk of amputation was 12 times greater for people with diabetes than for people without diabetes.
  
  
  CONCLUSIONS
  Investigation is needed into reasons for the unchanged incidence with respect to the provision of services from a range of disciplines, including vascular surgery, diabetes care, and multidisciplinary foot clinics.
  
  
  CONCLUSIONS
  This study shows an unchanged incidence of amputation over time and a high risk of amputation related to diabetes. Given the increased prevalence of diabetes and population aging, both of which present an increase in the population at risk of amputation, finding methods for reducing the rate of amputation is of importance.
authors: Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, The Netherlands. l.v.fortington@umcg.nl
authors: Lauren V
authors: LV
authors: Fortington
authors: Gerardus M
authors: GM
authors: Rommers
authors: Klaas
authors: K
authors: Postema
authors: Jaap J
authors: JJ
authors: van Netten
authors: Jan H B
authors: JH
authors: Geertzen
authors: Pieter U
authors: PU
authors: Dijkstra
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004188:Disarticulation / Q000706:statistics & numerical data*; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D015994:Incidence; D007717:Knee / Q000601:surgery*; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery
keywords: Diabetes; incidence; rehabilitation; rehabilitation of amputees