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Decreasing incidence of major amputation in diabetic patients: a consequence of a multidisciplinary foot care team approach?

Larsson, J; Apelqvist, Jan LU ; Agardh, Carl-David LU and Stenström, Anders LU (1995) In Diabetic Medicine 12(9). p.770-776
Abstract
The purpose of this retrospective study was to evaluate the changes in diabetes-related lower extremity amputations following the implementation of a multidisciplinary programme for prevention and treatment of diabetic foot ulcers in a 0.2 million population with a 2.4% prevalence of diabetes. All diabetes-related primary amputations from toe to hip from 1 January 1982 to 31 December 1993 were included. In 294 diabetic patients, 387 primary major (above the ankle) or minor (through or below the ankle) amputations were performed, constituting 48% of all lower extremity amputations. The annual number of amputations at all levels decreased from 38 to 21, equalling a decrease of incidence from 19.1 to 9.4/100,000 inhabitants (p = 0.001). The... (More)
The purpose of this retrospective study was to evaluate the changes in diabetes-related lower extremity amputations following the implementation of a multidisciplinary programme for prevention and treatment of diabetic foot ulcers in a 0.2 million population with a 2.4% prevalence of diabetes. All diabetes-related primary amputations from toe to hip from 1 January 1982 to 31 December 1993 were included. In 294 diabetic patients, 387 primary major (above the ankle) or minor (through or below the ankle) amputations were performed, constituting 48% of all lower extremity amputations. The annual number of amputations at all levels decreased from 38 to 21, equalling a decrease of incidence from 19.1 to 9.4/100,000 inhabitants (p = 0.001). The incidence of major amputations decreased by 78% from 16/1 to 3.6/100,000 inhabitants (p < 0.001). The absolute number of amputations with a final level below the ankle showed no increase, but their proportion increased from 28 to 53% (p < 0.001) and the reamputation rate decreased from 36 to 22% (p < 0.05) between the first and last 3-year period. Thus, a substantial long-term decrease in the incidence of major amputations was seen as well as a decrease in the total incidence of amputations in diabetic patients. Seventy-one per cent of the amputations were precipitated by a foot ulcer. These findings indicate that a multidisciplinary approach plays an important role to reduce and maintain a low incidence of major amputations in diabetic patients. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetic Medicine
volume
12
issue
9
pages
770 - 776
publisher
Wiley-Blackwell
external identifiers
  • pmid:8542736
  • scopus:0029127367
ISSN
1464-5491
language
English
LU publication?
yes
id
3cfc4c57-aa67-423c-a0c5-c3a1dc9286eb (old id 1109154)
date added to LUP
2008-07-25 14:28:55
date last changed
2017-09-17 07:29:39
@article{3cfc4c57-aa67-423c-a0c5-c3a1dc9286eb,
  abstract     = {The purpose of this retrospective study was to evaluate the changes in diabetes-related lower extremity amputations following the implementation of a multidisciplinary programme for prevention and treatment of diabetic foot ulcers in a 0.2 million population with a 2.4% prevalence of diabetes. All diabetes-related primary amputations from toe to hip from 1 January 1982 to 31 December 1993 were included. In 294 diabetic patients, 387 primary major (above the ankle) or minor (through or below the ankle) amputations were performed, constituting 48% of all lower extremity amputations. The annual number of amputations at all levels decreased from 38 to 21, equalling a decrease of incidence from 19.1 to 9.4/100,000 inhabitants (p = 0.001). The incidence of major amputations decreased by 78% from 16/1 to 3.6/100,000 inhabitants (p &lt; 0.001). The absolute number of amputations with a final level below the ankle showed no increase, but their proportion increased from 28 to 53% (p &lt; 0.001) and the reamputation rate decreased from 36 to 22% (p &lt; 0.05) between the first and last 3-year period. Thus, a substantial long-term decrease in the incidence of major amputations was seen as well as a decrease in the total incidence of amputations in diabetic patients. Seventy-one per cent of the amputations were precipitated by a foot ulcer. These findings indicate that a multidisciplinary approach plays an important role to reduce and maintain a low incidence of major amputations in diabetic patients.},
  author       = {Larsson, J and Apelqvist, Jan and Agardh, Carl-David and Stenström, Anders},
  issn         = {1464-5491},
  language     = {eng},
  number       = {9},
  pages        = {770--776},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetic Medicine},
  title        = {Decreasing incidence of major amputation in diabetic patients: a consequence of a multidisciplinary foot care team approach?},
  volume       = {12},
  year         = {1995},
}