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) All Versions of this Article: dc07-1159v1 31/3/459    most recent 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 Canavan, R. J. Articles by Connolly, V. M. Search for Related Content PubMed PubMed Citation Articles by Canavan, R. J. Articles by Connolly, V. M. Social Bookmarking                What's this?

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

¹ Diabetes Care Centre, James Cook University Hospital, Middlesborough, U.K
² Institute of Health and Society, Newcastle University, The Medical School, Newcastle upon Tyne, U.K

Address correspondence and reprint requests to Ronan J. Canavan, Diabetes Day Centre, St. Columcille's Hospital, Loughlintown Co., Dublin, Ireland. E-mail: ronan.canavan{at}hse.ie

OBJECTIVE—There is a lack of continuous longitudinal population-based data on lower extremity amputation (LEA) in the U.K. We present here accurate data on trends in diabetes-related (DR) LEAs and non-DRLEAs in the South Tees area over a continuous 5-year period.

RESEARCH DESIGN AND METHODS—All cases of LEA from 1 July 1995 to 30 June 2000 within the area were identified. Estimated ascertainment using capture-recapture analysis approached 100% for LEAs in the area. Data were collected longitudinally using the standard method of the Global Lower Extremity Amputation Study protocol.

RESULTS—Over 5 years there were 454 LEAs (66.3% men) in the South Tees area, of which 223 were diabetes related (49.1%). Among individuals with diabetes, LEA rates went from 564.3 in the first year to 176.0 of 100,000 persons with diabetes in the fifth year. Over the same period, non-DRLEAs increased from 12.3 to 22.8 of 100,000 persons without diabetes. The relative risk of a person with diabetes undergoing an LEA went from being 46 times that of a person without diabetes to 7.7 at the end of the 5 years. The biggest improvement in LEA incidence was seen in the reduction of repeat major DRLEAs.

CONCLUSIONS—Our data show that in the South Tees area at a time when major non-DRLEA rates increased, major DRLEA rates have fallen. These diverging trends mark a significant improvement in care for patients with diabetic foot disease as a result of better organized diabetes care.

Abbreviations: DR, diabetes related • GLEAS, Global Lower Extremity Amputation Study • HES, hospital event statistics • LEA, lower extremity amputation

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

This article has been cited by other articles:

				H. Hosalkar, J. Hsu, N. K. Pandya, and M. A. Keenan What's New in Orthopaedic Rehabilitation J. Bone Joint Surg. Am., October 1, 2008; 90(10): 2301 - 2311. [Full Text] [PDF]