Variation in the recorded incidence of amputation of the lower limb in England
Aims/hypothesis The study aimed to explore the variation in recorded incidence of lower limb amputation in England. Methods The incidences of amputations in adults with and without diabetes were determined from hospital episode statistics over 3 years to 31 March 2010 and compared between the 151 Pr...
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| Veröffentlicht in: | Diabetologia 2012-07, Vol.55 (7), p.1919-1925 |
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| container_title | Diabetologia |
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| creator | Holman, N. Young, R. J. Jeffcoate, W. J. |
| description | Aims/hypothesis
The study aimed to explore the variation in recorded incidence of lower limb amputation in England.
Methods
The incidences of amputations in adults with and without diabetes were determined from hospital episode statistics over 3 years to 31 March 2010 and compared between the 151 Primary Care Trusts (PCTs) in England.
Results
There were 34,109 amputations, including 16,693 (48.9%) in people with diabetes. The incidence was 2.51 per 1,000 person-years in people with diabetes and 0.11 per 1,000 person-years in people without (relative diabetes risk 23.3). Incidence varied eightfold across PCTs in people both with diabetes (range 0.64–5.25 per 1,000 person-years) and without (0.03–0.24 per 1,000 person-years). Amputations in people with diabetes varied tenfold—both major (range 0.22–2.20 per 1,000 person-years) and minor (range 0.30–3.25 per 1,000 person-years). The incidences of minor and major amputations were positively correlated both in those with (
r
= 0.537,
p
|
| doi_str_mv | 10.1007/s00125-012-2468-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1019617219</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1019617219</sourcerecordid><originalsourceid>FETCH-LOGICAL-c511t-c0651d5a7b6241cf3457e31a362cbce4b4889a81d4f75975c7073d8eec7177693</originalsourceid><addsrcrecordid>eNp10ElLxTAQB_Agij6XD-BFCiJ4qWbSbD2KuMFDLyreSppOn5Uuz6RF_Pam9rkgeEkY8pvJ8CdkH-gJUKpOPaXARByOmHGpY7lGZsATFlPO9DqZjc8xaPm0Rba9f6GUJoLLTbLFWJJqycWM3D4aV5m-6tqoaqP-GSOHtnMFFqG2VYGtxagrI9Msh35yoRpd3b2hi-qqycfOi3ZRm7bYJRulqT3ure4d8nB5cX9-Hc_vrm7Oz-axFQB9bKkUUAijcsk42DLhQmECJpHM5hZ5zrVOjYaCl0qkSlhFVVJoRKtAKZkmO-R4mrt03euAvs-aylusww7YDT4DCqkExWCkh3_oSze4Nmw3Kq0FFZ8KJmVd573DMlu6qjHuPaBsDDubws7CkY1hZzL0HKwmD3mDxXfHV7oBHK2A8dbUpTMhUv_jRKqB09Gxyfnw1C7Q_V7xv98_AJ0KlIc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1018850519</pqid></control><display><type>article</type><title>Variation in the recorded incidence of amputation of the lower limb in England</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Holman, N. ; Young, R. J. ; Jeffcoate, W. J.</creator><creatorcontrib>Holman, N. ; Young, R. J. ; Jeffcoate, W. J.</creatorcontrib><description>Aims/hypothesis
The study aimed to explore the variation in recorded incidence of lower limb amputation in England.
Methods
The incidences of amputations in adults with and without diabetes were determined from hospital episode statistics over 3 years to 31 March 2010 and compared between the 151 Primary Care Trusts (PCTs) in England.
Results
There were 34,109 amputations, including 16,693 (48.9%) in people with diabetes. The incidence was 2.51 per 1,000 person-years in people with diabetes and 0.11 per 1,000 person-years in people without (relative diabetes risk 23.3). Incidence varied eightfold across PCTs in people both with diabetes (range 0.64–5.25 per 1,000 person-years) and without (0.03–0.24 per 1,000 person-years). Amputations in people with diabetes varied tenfold—both major (range 0.22–2.20 per 1,000 person-years) and minor (range 0.30–3.25 per 1,000 person-years). The incidences of minor and major amputations were positively correlated both in those with (
r
= 0.537,
p
< 0.0005) and without (
r
= 0.611,
p
< 0.0005) diabetes. Incidences of amputations were also correlated between people with and without diabetes (total amputations
r
= 0.433,
p
< 0.0005; major amputations
r
= 0.528,
p
< 0.0005). There was a negative correlation between the incidence of amputation and estimated prevalence of ethnic Asians. No association was found between the PCT incidence of either total amputations and general population prevalence of social deprivation (
r
= −0.138,
p
= 0.092) or smoking (
r
= 0.137,
p
= 0.096).
Conclusions/interpretation
Variation in amputation incidence occurs across England. Because of the similarity in amputation variation between people with and without diabetes the variation may reflect generic differences in local healthcare delivery, although racial factors may also contribute.</description><identifier>ISSN: 0012-186X</identifier><identifier>EISSN: 1432-0428</identifier><identifier>DOI: 10.1007/s00125-012-2468-6</identifier><identifier>PMID: 22398645</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adolescent ; Adult ; Aged ; Amputation ; Amputation - statistics & numerical data ; Analysis of Variance ; Ankle ; Associated diseases and complications ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Diabetes ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 2 - complications ; Diabetes. Impaired glucose tolerance ; Diabetic Foot - epidemiology ; Diabetic Foot - surgery ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Endocrine pancreas. Apud cells (diseases) ; Endocrinology ; Endocrinopathies ; England - epidemiology ; Ethnic Groups - statistics & numerical data ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Foot diseases ; Health care delivery ; Health services ; Health Services Accessibility ; Healthcare Disparities - statistics & numerical data ; Hospitals ; Human Physiology ; Humans ; Incidence ; Internal Medicine ; Lower Extremity - surgery ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Middle Aged ; Minority & ethnic groups ; Prevalence ; Primary care ; Risk Factors ; Young Adult</subject><ispartof>Diabetologia, 2012-07, Vol.55 (7), p.1919-1925</ispartof><rights>Springer-Verlag 2012</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c511t-c0651d5a7b6241cf3457e31a362cbce4b4889a81d4f75975c7073d8eec7177693</citedby><cites>FETCH-LOGICAL-c511t-c0651d5a7b6241cf3457e31a362cbce4b4889a81d4f75975c7073d8eec7177693</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00125-012-2468-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00125-012-2468-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25981405$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22398645$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Holman, N.</creatorcontrib><creatorcontrib>Young, R. J.</creatorcontrib><creatorcontrib>Jeffcoate, W. J.</creatorcontrib><title>Variation in the recorded incidence of amputation of the lower limb in England</title><title>Diabetologia</title><addtitle>Diabetologia</addtitle><addtitle>Diabetologia</addtitle><description>Aims/hypothesis
The study aimed to explore the variation in recorded incidence of lower limb amputation in England.
Methods
The incidences of amputations in adults with and without diabetes were determined from hospital episode statistics over 3 years to 31 March 2010 and compared between the 151 Primary Care Trusts (PCTs) in England.
Results
There were 34,109 amputations, including 16,693 (48.9%) in people with diabetes. The incidence was 2.51 per 1,000 person-years in people with diabetes and 0.11 per 1,000 person-years in people without (relative diabetes risk 23.3). Incidence varied eightfold across PCTs in people both with diabetes (range 0.64–5.25 per 1,000 person-years) and without (0.03–0.24 per 1,000 person-years). Amputations in people with diabetes varied tenfold—both major (range 0.22–2.20 per 1,000 person-years) and minor (range 0.30–3.25 per 1,000 person-years). The incidences of minor and major amputations were positively correlated both in those with (
r
= 0.537,
p
< 0.0005) and without (
r
= 0.611,
p
< 0.0005) diabetes. Incidences of amputations were also correlated between people with and without diabetes (total amputations
r
= 0.433,
p
< 0.0005; major amputations
r
= 0.528,
p
< 0.0005). There was a negative correlation between the incidence of amputation and estimated prevalence of ethnic Asians. No association was found between the PCT incidence of either total amputations and general population prevalence of social deprivation (
r
= −0.138,
p
= 0.092) or smoking (
r
= 0.137,
p
= 0.096).
Conclusions/interpretation
Variation in amputation incidence occurs across England. Because of the similarity in amputation variation between people with and without diabetes the variation may reflect generic differences in local healthcare delivery, although racial factors may also contribute.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Amputation</subject><subject>Amputation - statistics & numerical data</subject><subject>Analysis of Variance</subject><subject>Ankle</subject><subject>Associated diseases and complications</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Foot - epidemiology</subject><subject>Diabetic Foot - surgery</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinology</subject><subject>Endocrinopathies</subject><subject>England - epidemiology</subject><subject>Ethnic Groups - statistics & numerical data</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>Foot diseases</subject><subject>Health care delivery</subject><subject>Health services</subject><subject>Health Services Accessibility</subject><subject>Healthcare Disparities - statistics & numerical data</subject><subject>Hospitals</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Internal Medicine</subject><subject>Lower Extremity - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Middle Aged</subject><subject>Minority & ethnic groups</subject><subject>Prevalence</subject><subject>Primary care</subject><subject>Risk Factors</subject><subject>Young Adult</subject><issn>0012-186X</issn><issn>1432-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp10ElLxTAQB_Agij6XD-BFCiJ4qWbSbD2KuMFDLyreSppOn5Uuz6RF_Pam9rkgeEkY8pvJ8CdkH-gJUKpOPaXARByOmHGpY7lGZsATFlPO9DqZjc8xaPm0Rba9f6GUJoLLTbLFWJJqycWM3D4aV5m-6tqoaqP-GSOHtnMFFqG2VYGtxagrI9Msh35yoRpd3b2hi-qqycfOi3ZRm7bYJRulqT3ure4d8nB5cX9-Hc_vrm7Oz-axFQB9bKkUUAijcsk42DLhQmECJpHM5hZ5zrVOjYaCl0qkSlhFVVJoRKtAKZkmO-R4mrt03euAvs-aylusww7YDT4DCqkExWCkh3_oSze4Nmw3Kq0FFZ8KJmVd573DMlu6qjHuPaBsDDubws7CkY1hZzL0HKwmD3mDxXfHV7oBHK2A8dbUpTMhUv_jRKqB09Gxyfnw1C7Q_V7xv98_AJ0KlIc</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Holman, N.</creator><creator>Young, R. J.</creator><creator>Jeffcoate, W. J.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20120701</creationdate><title>Variation in the recorded incidence of amputation of the lower limb in England</title><author>Holman, N. ; Young, R. J. ; Jeffcoate, W. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c511t-c0651d5a7b6241cf3457e31a362cbce4b4889a81d4f75975c7073d8eec7177693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Amputation</topic><topic>Amputation - statistics & numerical data</topic><topic>Analysis of Variance</topic><topic>Ankle</topic><topic>Associated diseases and complications</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Foot - epidemiology</topic><topic>Diabetic Foot - surgery</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinology</topic><topic>Endocrinopathies</topic><topic>England - epidemiology</topic><topic>Ethnic Groups - statistics & numerical data</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>Foot diseases</topic><topic>Health care delivery</topic><topic>Health services</topic><topic>Health Services Accessibility</topic><topic>Healthcare Disparities - statistics & numerical data</topic><topic>Hospitals</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Internal Medicine</topic><topic>Lower Extremity - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Middle Aged</topic><topic>Minority & ethnic groups</topic><topic>Prevalence</topic><topic>Primary care</topic><topic>Risk Factors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Holman, N.</creatorcontrib><creatorcontrib>Young, R. J.</creatorcontrib><creatorcontrib>Jeffcoate, W. J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetologia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Holman, N.</au><au>Young, R. J.</au><au>Jeffcoate, W. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Variation in the recorded incidence of amputation of the lower limb in England</atitle><jtitle>Diabetologia</jtitle><stitle>Diabetologia</stitle><addtitle>Diabetologia</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>55</volume><issue>7</issue><spage>1919</spage><epage>1925</epage><pages>1919-1925</pages><issn>0012-186X</issn><eissn>1432-0428</eissn><abstract>Aims/hypothesis
The study aimed to explore the variation in recorded incidence of lower limb amputation in England.
Methods
The incidences of amputations in adults with and without diabetes were determined from hospital episode statistics over 3 years to 31 March 2010 and compared between the 151 Primary Care Trusts (PCTs) in England.
Results
There were 34,109 amputations, including 16,693 (48.9%) in people with diabetes. The incidence was 2.51 per 1,000 person-years in people with diabetes and 0.11 per 1,000 person-years in people without (relative diabetes risk 23.3). Incidence varied eightfold across PCTs in people both with diabetes (range 0.64–5.25 per 1,000 person-years) and without (0.03–0.24 per 1,000 person-years). Amputations in people with diabetes varied tenfold—both major (range 0.22–2.20 per 1,000 person-years) and minor (range 0.30–3.25 per 1,000 person-years). The incidences of minor and major amputations were positively correlated both in those with (
r
= 0.537,
p
< 0.0005) and without (
r
= 0.611,
p
< 0.0005) diabetes. Incidences of amputations were also correlated between people with and without diabetes (total amputations
r
= 0.433,
p
< 0.0005; major amputations
r
= 0.528,
p
< 0.0005). There was a negative correlation between the incidence of amputation and estimated prevalence of ethnic Asians. No association was found between the PCT incidence of either total amputations and general population prevalence of social deprivation (
r
= −0.138,
p
= 0.092) or smoking (
r
= 0.137,
p
= 0.096).
Conclusions/interpretation
Variation in amputation incidence occurs across England. Because of the similarity in amputation variation between people with and without diabetes the variation may reflect generic differences in local healthcare delivery, although racial factors may also contribute.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22398645</pmid><doi>10.1007/s00125-012-2468-6</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0012-186X |
| ispartof | Diabetologia, 2012-07, Vol.55 (7), p.1919-1925 |
| issn | 0012-186X 1432-0428 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1019617219 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Adolescent Adult Aged Amputation Amputation - statistics & numerical data Analysis of Variance Ankle Associated diseases and complications Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Diabetes Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 2 - complications Diabetes. Impaired glucose tolerance Diabetic Foot - epidemiology Diabetic Foot - surgery Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Endocrine pancreas. Apud cells (diseases) Endocrinology Endocrinopathies England - epidemiology Ethnic Groups - statistics & numerical data Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Foot diseases Health care delivery Health services Health Services Accessibility Healthcare Disparities - statistics & numerical data Hospitals Human Physiology Humans Incidence Internal Medicine Lower Extremity - surgery Male Medical sciences Medicine Medicine & Public Health Metabolic Diseases Middle Aged Minority & ethnic groups Prevalence Primary care Risk Factors Young Adult |
| title | Variation in the recorded incidence of amputation of the lower limb in England |
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