The Epidemiology of Lower-Extremity Disease in Veterans With Diabetes
- Jennifer A. Mayfield, MD, MPH1,
- Gayle E. Reiber, PHD, MPH1234,
- Charles Maynard, PHD23,
- Joseph Czerniecki, MD15 and
- Bruce Sangeorzan, MD16
- 1Center of Excellence in Amputation, Prosthetics and Limb Loss Prevention, Rehabilitation, Research and Development, Seattle, Washington
- 2Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- 3Department of Health Services, University of Washington, Seattle, Washington
- 4Department of Epidemiology, University of Washington, Seattle, Washington
- 5Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
- 6Department of Orthopedic Surgery, University of Washington, Seattle, Washington
- Address correspondence and reprint requests to Gayle E. Reiber, MPH, PhD, VA Puget Sound Health Care System (152), 1660 South Columbian Way, Seattle, WA 98108. E-mail: greiber{at}u.washington.edu
Abstract
OBJECTIVE—To describe the epidemiology of lower-extremity complications of diabetes in veterans who are users of the Department of Veterans Affairs (VA).
RESEARCH DESIGN AND METHODS—Hospital discharge records for care provided in all VA hospitals in 1998 were obtained. All hospitalizations for lower-extremity ulceration, peripheral vascular procedures, and amputation were analyzed using frequency tables. A diabetes denominator was defined as a veteran with at least three ambulatory care visits with at least one diabetes diagnosis code. Age-specific and total age-adjusted rates of discharge with ulceration, vascular procedures, and amputation were calculated.
RESULTS—Veterans with diabetes comprised over half of all hospitalizations for lower-extremity ulceration, one-third of all hospitalizations for peripheral vascular procedures, and two-thirds of all hospitalizations for amputation. The age-specific discharge rate per 1,000 diabetic persons for age 0–64 years, 65–74 years, and 75 years and older for ulceration were 28.4, 31.0, and 37.9; for vascular procedures, the rates were 3.5, 4.4, and 4.4; and for amputation, the rates were 7.3, 9.0, and 10.0, respectively.
CONCLUSIONS—Veterans with diabetes comprise a significant proportion of hospitalizations for lower-extremity ulceration, peripheral vascular bypass, and amputation. Age-specific rates of diabetic amputation in veterans are lower than U.S. rates.
Footnotes
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Funding for this supplement was provided by The Seattle Epidemiologic Research and Information Center and the VA Cooperative Studies Program.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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- Accepted July 25, 2003.
- Received July 1, 2003.
- DIABETES CARE
