HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Trautner, C. Articles by Berger, M. Search for Related Content PubMed PubMed Citation Articles by Trautner, C. Articles by Berger, M. Social Bookmarking                What's this?

Unchanged Incidence of Lower-Limb Amputations in a German City, 1990–1998

¹ University of Bielefeld, School of Public Health, Bielefeld, Germany
² Department of Biometrics and Epidemiology, German Diabetes Research Institute at Heinrich Heine University
³ Department of Metabolic Diseases and Nutrition, (World Health Organization Collaborating Center for Diabetes), Heinrich Heine University, Düsseldorf, Germany

OBJECTIVE—A reduction of diabetes-related amputations by at least one-half within 5 years was declared a primary objective for Europe (St. Vincent Declaration, 1989). We collected data about incidence rates of amputations in one German city (Leverkusen, with a population of 160,000 inhabitants) between 1990 and 1998 to ascertain a potential change in rates of incidence.

RESEARCH DESIGN AND METHODS—From all three hospitals in Leverkusen, we obtained complete lists of lower-limb amputations. From each patient record, diabetic status was determined. Only the first observed amputation was counted for the analysis. We estimated incidence rates of amputations in the entire population, the diabetic population, and the nondiabetic population. To test for time trend, we fitted Poisson regression models, adjusting for age and sex.

RESULTS—During the defined period (the years 1990, 1991, and 1994–1998), 339 patients (all residents of Leverkusen) without previous amputations had nontraumatic lower-limb amputations. Of all subjects, 46% were female. Moreover, 76% of the subjects were known to have diabetes. Mean age was 71.3 years. Incidence rates in the diabetic population (standardized to the estimated German diabetic population, per 100,000 person-years) were as follows: 1990, 549; 1991, 356; 1994, 544; 1995, 386; 1996, 426; 1997, 433; and 1998, 463. The Poisson models showed no significant change of incident amputations over time in the diabetic population or in the nondiabetic population.

CONCLUSIONS—Beyond random variation, no change of incidence rates could be observed over the past 9 years. More specific interventions are needed to achieve a substantial reduction of diabetes-related amputations.

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				R. J. Canavan, N. C. Unwin, W. F. Kelly, and V. M. Connolly Diabetes- and Nondiabetes-Related Lower Extremity Amputation Incidence Before and After the Introduction of Better Organized Diabetes Foot Care: Continuous longitudinal monitoring using a standard method Diabetes Care, March 1, 2008; 31(3): 459 - 463. [Abstract] [Full Text] [PDF]

				S. Krishnan, F. Nash, N. Baker, D. Fowler, and G. Rayman Reduction in Diabetic Amputations Over 11 Years in a Defined U.K. Population: Benefits of multidisciplinary team work and continuous prospective audit Diabetes Care, January 1, 2008; 31(1): 99 - 101. [Abstract] [Full Text] [PDF]

				C.-L. Tseng, D. Helmer, M. Rajan, A. Tiwari, D. Miller, S. Crystal, M. Safford, J. Greenberg, and L. Pogach Evaluation of regional variation in total, major, and minor amputation rates in a national health-care system Int. J. Qual. Health Care, December 1, 2007; 19(6): 368 - 376. [Abstract] [Full Text] [PDF]

				C. Trautner, B. Haastert, P. Mauckner, L.-M. Gatcke, and G. Giani Reduced Incidence of Lower-Limb Amputations in the Diabetic Population of a German City, 1990 2005: Results of the Leverkusen Amputation Reduction Study (LARS) Diabetes Care, October 1, 2007; 30(10): 2633 - 2637. [Abstract] [Full Text] [PDF]

				R. Lobmann, G. Schultz, and H. Lehnert Proteases and the Diabetic Foot Syndrome: Mechanisms and Therapeutic Implications Diabetes Care, February 1, 2005; 28(2): 461 - 471. [Full Text] [PDF]

				W. H. van Houtum, J. A. Rauwerda, D. Ruwaard, N. C. Schaper, and K. Bakker Reduction in Diabetes-Related Lower-Extremity Amputations in the Netherlands: 1991-2000 Diabetes Care, May 1, 2004; 27(5): 1042 - 1046. [Abstract] [Full Text] [PDF]