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Decreasing incidence of major amputation in diabetic patients: a consequence of a multidisciplinary foot care team approach?

Author:
  • J Larsson
  • Jan Apelqvist
  • Carl-David Agardh
  • Anders Stenström
Publishing year: 1995
Language: English
Pages: 770-776
Publication/Series: Diabetic Medicine
Volume: 12
Issue: 9
Document type: Journal article
Publisher: Wiley-Blackwell

Abstract english

The purpose of this retrospective study was to evaluate the changes in diabetes-related lower extremity amputations following the implementation of a multidisciplinary programme for prevention and treatment of diabetic foot ulcers in a 0.2 million population with a 2.4% prevalence of diabetes. All diabetes-related primary amputations from toe to hip from 1 January 1982 to 31 December 1993 were included. In 294 diabetic patients, 387 primary major (above the ankle) or minor (through or below the ankle) amputations were performed, constituting 48% of all lower extremity amputations. The annual number of amputations at all levels decreased from 38 to 21, equalling a decrease of incidence from 19.1 to 9.4/100,000 inhabitants (p = 0.001). The incidence of major amputations decreased by 78% from 16/1 to 3.6/100,000 inhabitants (p < 0.001). The absolute number of amputations with a final level below the ankle showed no increase, but their proportion increased from 28 to 53% (p < 0.001) and the reamputation rate decreased from 36 to 22% (p < 0.05) between the first and last 3-year period. Thus, a substantial long-term decrease in the incidence of major amputations was seen as well as a decrease in the total incidence of amputations in diabetic patients. Seventy-one per cent of the amputations were precipitated by a foot ulcer. These findings indicate that a multidisciplinary approach plays an important role to reduce and maintain a low incidence of major amputations in diabetic patients.

Keywords

  • Endocrinology and Diabetes

Other

Published
  • Genomics, Diabetes and Endocrinology
  • ISSN: 1464-5491
E-mail: jan [dot] apelqvist [at] med [dot] lu [dot] se

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Genomics, Diabetes and Endocrinology

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