Epidemiology of Nontraumatic Lower-Extremity Amputation in Area 7, Madrid, Between 1989 and 1999

Calle-Pascual, Alfonso; Garcia-Torre, Nuria; Moraga, Inmaculada; Díaz, José; Durán, Alejandra; Moñux, Guillermo; Serrano, Francisco; Martín-Álvarez, Pedro J.; Charro, Aniceto; Marañes, Juan P.

doi:10.2337/diacare.24.9.1686

Cited by 79 publications

(78 citation statements)

References 11 publications

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“…A study in the Netherlands reported that diabetics were 20 times more likely to have a LLA than non-diabetics while male diabetic subjects were 20.5 times more likely to get a LLA than their nondiabetic counterparts and the female diabetics were 19.8 times more likely to get a LLA than their non-diabetic counterparts (Van Houtum et al 1996). Generally, research has shown that the incidence of LLA is gender related with higher rates in males (Gujral et al 1993;Calle-Pascual et al 1997;Moss et al 1999;The Global LEA Study Group 2000;Pernot et al 2000;Dillingham et al 2002;. Having high school education reduced the risk of LLA by more than 50% .…”

Section: Global Trends In Epidemiology Of Llamentioning

confidence: 99%

“…In a Madrid study on non-traumatic LLAs more than 80% of the subjects were over the age of 65 and retired, 5% unemployed and 2% working (Calle-Pascual et al 1997). A Brazilian study suggested that critical limb ischemia culminating in an amputation usually occurs at an advanced age, and thus increasing the inherent physical limitations of age (de Godoy et al 2005).…”

Section: Global Trends In Epidemiology Of Llamentioning

confidence: 99%

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Global trends in incidence of lower limb amputation: a review of the literature

Godlwana

Nadasan

Puckree

2008

South African Journal of Physiotherapy

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Section: Global Trends In Epidemiology Of Llamentioning

confidence: 99%

Section: Global Trends In Epidemiology Of Llamentioning

confidence: 99%

Global trends in incidence of lower limb amputation: a review of the literature

Godlwana

Nadasan

Puckree

2008

South African Journal of Physiotherapy

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“…However, some definitions include operations performed below the ankle but proximal to the tarso-metatarsal joints, including Syme's procedure and ankle disarticulation, or any operation that excludes the toes [16]. The terms 'lower extremity amputation' and 'lower limb amputation' are used with imprecision, with no distinction in practice between the terms 'extremity' and 'limb'.…”

Section: Major and Lower Extremity (Lower Limb) Amputationmentioning

confidence: 99%

“…Reports should ideally be based on comprehensive, population-wide, prospective capture of all relevant clinical activity, but this is not routinely possible. Publications have therefore required detailed work, with cross-checking of records, such as operating theatre and rehabilitation unit records [6,14,15], and the use of capture-recapture methods [16,17]. This situation should improve with the increasing adoption of comprehensive communitywide registers [18].…”

Section: Data Sources In Published Surveysmentioning

confidence: 99%

Amputation as a marker of the quality of foot care in diabetes

2004

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Strategic targets for the management of foot ulcers focus on reducing the incidence of amputation. While data on the incidence of amputation can be obtained relatively easily, the figures require very careful interpretation. Variation in the definition of amputation, population selection and the choice of numerator and denominator make comparisons difficult. Major and minor amputation have to be distinguished as they are undertaken for different reasons and are associated with different costs and functional implications. Many factors influence the decision of whether or not to remove a limb. In addition to disease severity, co-morbidities, and social and individual patient factors, many aspects of the structure of care services affect this decision, including access to primary care, quality of primary care, delays in referral, availability and quality of specialist resources, and prevailing medical opinion. It follows that a high incidence of amputation can reflect a higher disease prevalence, late referral, limited resources, or a particularly interventionist approach by a specialist team. Conversely, a low incidence of amputation can indicate a lower disease prevalence or severity, good management of diabetes in primary and secondary care, or a particularly conservative approach by an expert team. An inappropriately conservative approach could conceivably enhance suffering by condemning a person to months of incapacity before they die with an unhealed ulcer. The reported annual incidence of major amputation in industrialised countries ranges from 0.06 to 3.83 per 10 3 people at risk. Some centres have documented that the incidence is falling, but this is often from a baseline value that was unusually high. Other centres have reported that the incidence has not changed. The ultimate target is to achieve not only a decrease in incidence, but also a low overall incidence. This must be accompanied by improvements in morbidity, mortality, and patient function and mood.

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“…An estimated 3 to 6 million chronic skin ulcers occur in patients every year in the United States. The most common underlying conditions are venous reflux, pressure, and diabetes mellitus 1,2,3,4,5 In the vast majority of surgical procedures, nearly all acute wounds heal by an orderly and timely process 6 , with a strength and integrity similar to normal skin. 7,8 Wounds refractory to moist healing, however, may be candidates for growth factor therapy, which is assumed to stimulate missing or dysfunctional components of the chronic wound [9][10][11] .…”

Section: Introductionmentioning

confidence: 99%