The Effect of Limb Salvage Efforts in Different Age Groups : Relationships Between Major and Minor Amputations

Copyright © 2024 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved..

"Limb salvage" efforts, such as performing minor amputations before infections spread proximally from the foot to decrease major lower extremity amputation, are an important part of healthcare today. It is unclear whether these efforts are preventing the number of major amputations and improving patients' quality of life and the cost-effectiveness of the U.S. healthcare system. Rates of non-traumatic lower extremity amputation (NLEA) among patients with diabetes decreased in the early 2000s but rebounded in the 2010s. We analyzed the proportion of major amputations and differences in amputation rates between age groups in Texas. Patient data was extracted from the Texas Hospital Discharge Data Public Use Data File. Population estimates were obtained from the Texas Population Estimates Program from 2011 to 2015 and from intercensal estimates provided by the U.S. Census Bureau from 2006 to 2010. Raw numbers of minor, major, and all NLEA surgeries and the ratio of major amputations to total amputations per year were reported for each age group. Poisson regression and Joinpoint analyses were performed to capture these changes in trends. Rates of amputations increased, with significant decreasing relative prevalence of major amputations. Patients aged 45 to 64 with diabetes are likely driving these increases. Rates of lower extremity amputation in patients with diabetes increased from 2009 to 2015. This holds for all and minor amputations. In contrast, the ratio of major to all amputations decreased from 2010. Utilization of major and minor amputation differs between age groups, remaining stable in the youngest subjects, with minor amputation rates increasing in those aged 45 to 64.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:63

Enthalten in:

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons - 63(2024), 3 vom: 04. Apr., Seite 380-385

Sprache:

Englisch

Beteiligte Personen:

Song, Wenye [VerfasserIn]
La Fontaine, Javier [VerfasserIn]
Shibuya, Naohiro [VerfasserIn]
Prochaska, John [VerfasserIn]
Jupiter, Daniel C [VerfasserIn]

Links:

Volltext

Themen:

Age factors
Amputation
Diabetes mellitus
Diabetic complications
Journal Article
Lower extremity
Population characteristics

Anmerkungen:

Date Completed 26.04.2024

Date Revised 26.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1053/j.jfas.2024.01.010

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM36757229X