Since 1972 the Danish Amputation Register (DAR) has recorded major amputations in Denmark. The register is based on voluntary detailed reports from surgical and orthopaedic departments. The present investigation is based upon 2029 amputations for arteriosclerotic and diabetic gangrene with an observation period up to 4 years. The incidence of ipsilateral reamputation is high in the immediate postoperative period with 10-4% after one month, 16-5% after three months and 18-8% after six months. Later the incidence is quite low, reaching a total of 23-1% after four years. The risk of contralateral amputation is ever present with an incidence of 11-9% within one year, 17-8% after two years, 27-2% after three years, and finally 44-3% after four years. The mortality after three months is 16-3% and then tapers off to a total of 22-5% after four years. As compared with the normal population a significant over-mortality is seen during the first three months, and an equally significant under-mortality from six months onward during the observation period.

This study analyses 2848 primary major lower limb amputations in diabetic individuals during the period 1982-1993. The male:female sex ratio (mean 1.18) increased, while the mean age at the primary amputation was constant (70.96 years) during the period. The incidence uniformly decreased for both men and women by 0.96 per year. A subdivision of the total population into three age groups (< 50, 50-70, > 70 years), shows a 0.95 decrease per year with no significant difference between the groups. The decrease in incidence during the period 1987-1993 appeared specifically related to insulin-dependent diabetes mellitus (0.92), whereas the incidence of amputations in non-insulin-dependent diabetic patients was constant. The overall decrease of incidence during the period (40%) does not fully meet the target specified in the St. Vincent Declaration.

On a well defined non-diabetic amputation group with vascular insufficiency consisting of 10,191 amputations during the period 1982 to 1992 the Standard Mortality Rate (SMR) and the long term survival (Kaplan-Meyer) were analysed. The SMR for the total group was 8.6 (8.4–8.9) times the expected mortality the first year after amputation, decreasing to 3.2 (3.3–3.4) the second year. SMR in relation to age, gender and level of amputation was analysed. In the long term survival studies the median survival time (50% survival) for the total group was 1.8 years. Significant relation was found between the long term survival and gender, age and level of amputation.

Upper extremity amputations in Denmark between 1978 and 1983 comprised 3 percent of all major amputations. Trauma was the main reason for upper extremity amputations.