Article

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. STUDY DESIGN: 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. OBJECTIVES: 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. CLINICAL RELEVANCE: 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.

Langue : ANGLAIS