Lower limb amputations

Abstract

The purpose of the study was to evaluate possible differences between genders in amputation incidence, revascularization activity before and survival after amputation. This population-based study was carried out in a well-defined geographical area, where all vascular surgical consultations and reconstructions are performed in one university hospital. All amputations performed in the region during 1990 -1999 were identified from the hospital central registers. According to patient's identity codes, the Cause of Death Registry of Statistics Finland provided death data. Amputation data were cross-linked with the local vascular registry using identity codes. Women were found to be 8 years older than men (p 5 0.0001). Major amputations comprised 73.4% in males and 77.7% in females. The age-standardized amputation incidence among males was 338 and among females 226 (per 10 6 inhabitants/year) (p 5 0.001). The most prominent difference was seen in amputations due to trauma, where the age-adjusted major amputation incidence was over three-fold among males compared to females. The proportion of patients who had undergone vascular procedure before amputation was 23% in both genders. Median survival after amputation was 943 days in men and 716 in women (p ¼ 0.01). When the higher age of women was considered, there was no significant difference between the genders. Survival was poorer among diabetics in both genders and the difference was significant in males. The amputation incidence was found to be higher in men compared to women in all etiologic subgroups except malignant tumour. Almost one in 4 patients had undergone vascular surgical reconstruction before amputation in both genders. There was no significant difference between the genders in survival after amputation. Subjects with diabetes had a poorer survival after major amputation than those without diabetes.

Incidence of Lower-Limb Amputation in the Diabetic and Nondiabetic General Population

“…A rate of 9 per 100,000 person-years was reported in a German city population with a mean age 10 years lower than that for our study population (6), and a rate of 12 per 100,000 personyears was reported in a Dutch population (14). However, a Finnish study has reported a higher incidence of 23 per 100,000 person-years (15).…”

“…Our study showed a significantly higher risk for amputation in diabetic men aged Ն85 years. A Finnish population study showed that men have a significantly higher risk of vascular amputation than women (15).…”

Factors affecting quality of life in lower limb amputees

“…A similar higher prevalence of amputation among males has been observed in other studies. 40,41 The unemployed status of male members can have a direct impact on the family's income and living standards, since in India the male is traditionally the primary earning member of the family. 42,43 This might explain the important role of employment status in determining QoL in amputees, as unemployment may be distressing for an individual and potentially affect his mental functioning, as observed in this study.…”

Community-based survey of amputation derived from the physically disabled person’s certification in Kitakyushu City, Japan

“…[1][2][3][4][5][6] Dillingham et al conducted a nine-year survey covering 11 states in the USA from 1988 to 1996, and found that the incidence of amputation was 52.4/100,000 population per year, wherein 82% were due to peripheral vascular disorder. 4 The incidence of amputation due to peripheral vascular disorder increased from 38.3 to 46.2 during this nine-year period, traumarelated amputation decreased from 11.4 to 5.9, and amputation due to malignant tumors slightly decreased from 0.6 to 0.4, while congenital deficiency accounted for 0.8% of all amputations without any change.…”