title: The prevalence of major lower limb amputation in the diabetic and non-diabetic population of England 2003-2013.
abstract: To determine the prevalence of amputation and revascularisation among diabetics and non-diabetics between 2003 and 2013.
  
  
  
  Retrospective analysis of English hospital data with census estimates for population aged 50-84 years.
  
  
  
  There were 42,294 major and 52,525 minor amputations and 355,545 revascularisations. Major amputation rates fell by 20% (27.7-22.9), with minor amputations (22.9-35.2) and revascularisations (199.8-245.4) rising. The major amputation rate reduced in diabetics (men, 180.5-111.8; women, 92.8-52.7) faster than non-diabetics (men, 24.6-18.7; women, 11.0-8.9). In total, 48.2% of men and 58.0% of women amputees were not diabetic.
  
  
  
  Diabetics continue to experience six times the rate of amputation than non-diabetics. However, half of major amputees were not diabetic and experienced slower rates of decrease. Non-diabetics, particularly those with peripheral arterial disease, should have access to appropriate services, particularly foot care.
authors.affiliation: Department of Vascular and Endovascular Surgery, Manchester Royal Infirmary, Manchester, UK naseer.ahmad@cmft.nhs.uk.
authors.forename: Naseer
authors.initials: N
authors.lastname: Ahmad
authors.affiliation: University of Birmingham, Birmingham, UK.
authors.forename: G Neil
authors.initials: GN
authors.lastname: Thomas
authors.affiliation: University of Birmingham, Birmingham, UK.
authors.forename: Paramjit
authors.initials: P
authors.lastname: Gill
authors.affiliation: Liverpool Vascular and Endovascular Service (LiVES), Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Francesco
authors.initials: F
authors.lastname: Torella
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000639:trends*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D023821:Limb Salvage / Q000639:trends; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000639:trends*
keywords: Amputation; endovascular; peripheral arterial disease; revascularisation