Advanced

Sustained reduction in major amputations in diabetic patients - 628 amputations in 461 patients in a defined population over a 20-year period

Larsson, Jan; Eneroth, Magnus LU ; Apelqvist, Jan LU and Stenström, Anders LU (2008) In Acta Orthopaedica 79(5). p.665-673
Abstract
Background and purpose With an ageing population and an increasing incidence of diabetes, reduction of the number of diabetes-related amputations becomes increasingly difficult to achieve and maintain. There is controversy in this respect regarding the degree of success. We started a multidisciplinary treatment program for diabetic foot ulcers in 1982, and have now assessed incidence rates of amputations from 1982 through 2001. Methods In a defined population, gradually increasing from 199,000 to 234,000, all diabetes-related amputations of the lower extremity from toe to hip were recorded from January 1, 1982 to December 31, 2001, using several sources of information. Results The incidence of major amputations decreased by 0.57 from 16... (More)
Background and purpose With an ageing population and an increasing incidence of diabetes, reduction of the number of diabetes-related amputations becomes increasingly difficult to achieve and maintain. There is controversy in this respect regarding the degree of success. We started a multidisciplinary treatment program for diabetic foot ulcers in 1982, and have now assessed incidence rates of amputations from 1982 through 2001. Methods In a defined population, gradually increasing from 199,000 to 234,000, all diabetes-related amputations of the lower extremity from toe to hip were recorded from January 1, 1982 to December 31, 2001, using several sources of information. Results The incidence of major amputations decreased by 0.57 from 16 (11-22) to 6.8 (6.1-7.5) per 100,000 inhabitants between the first and last 4-year period. The most substantial decrease was seen in patients aged 80 years and older. The fraction of amputations with a final level at or below the ankle (n = 240) increased from 0.23 in the first 4-year period to 0.31, 0.49, 0.47, and 0.49 in the following 4-year periods. The overall fraction of re-amputation was 0.34 in the first 4-year period and 0.27, 0.21, 0.32, and 0.21 in the following 4-year periods. The fraction of amputations in diabetic patients that were channeled through the footcare team prior to amputation increased from 0.51 in the first 4-year period to 0.83, 0.86, 0.90, and 0.90 in the following 4-year periods. Interpretation Our findings indicate that a substantial decrease in the incidence of major lower extremity amputations in diabetic patients has been achieved and maintained. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Leg: surgery, Diabetic Foot: surgery, Sweden: epidemiology, Diabetic Foot: prevention & control, Amputation: statistics & numerical data, Diabetic Foot: epidemiology
in
Acta Orthopaedica
volume
79
issue
5
pages
665 - 673
publisher
Taylor & Francis
external identifiers
  • wos:000259779300014
  • pmid:18839374
  • scopus:53449090218
ISSN
1745-3682
DOI
10.1080/17453670810016696
language
English
LU publication?
yes
id
8628f6c6-50a0-460e-828f-c9b05485a031 (old id 1285943)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18839374?dopt=Abstract
date added to LUP
2009-02-04 10:38:19
date last changed
2017-01-01 06:27:22
@article{8628f6c6-50a0-460e-828f-c9b05485a031,
  abstract     = {Background and purpose With an ageing population and an increasing incidence of diabetes, reduction of the number of diabetes-related amputations becomes increasingly difficult to achieve and maintain. There is controversy in this respect regarding the degree of success. We started a multidisciplinary treatment program for diabetic foot ulcers in 1982, and have now assessed incidence rates of amputations from 1982 through 2001. Methods In a defined population, gradually increasing from 199,000 to 234,000, all diabetes-related amputations of the lower extremity from toe to hip were recorded from January 1, 1982 to December 31, 2001, using several sources of information. Results The incidence of major amputations decreased by 0.57 from 16 (11-22) to 6.8 (6.1-7.5) per 100,000 inhabitants between the first and last 4-year period. The most substantial decrease was seen in patients aged 80 years and older. The fraction of amputations with a final level at or below the ankle (n = 240) increased from 0.23 in the first 4-year period to 0.31, 0.49, 0.47, and 0.49 in the following 4-year periods. The overall fraction of re-amputation was 0.34 in the first 4-year period and 0.27, 0.21, 0.32, and 0.21 in the following 4-year periods. The fraction of amputations in diabetic patients that were channeled through the footcare team prior to amputation increased from 0.51 in the first 4-year period to 0.83, 0.86, 0.90, and 0.90 in the following 4-year periods. Interpretation Our findings indicate that a substantial decrease in the incidence of major lower extremity amputations in diabetic patients has been achieved and maintained.},
  author       = {Larsson, Jan and Eneroth, Magnus and Apelqvist, Jan and Stenström, Anders},
  issn         = {1745-3682},
  keyword      = {Leg: surgery,Diabetic Foot: surgery,Sweden: epidemiology,Diabetic Foot: prevention & control,Amputation: statistics & numerical data,Diabetic Foot: epidemiology},
  language     = {eng},
  number       = {5},
  pages        = {665--673},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Sustained reduction in major amputations in diabetic patients - 628 amputations in 461 patients in a defined population over a 20-year period},
  url          = {http://dx.doi.org/10.1080/17453670810016696},
  volume       = {79},
  year         = {2008},
}