ORLANDO — Trends in the rate of diabetes-related nontraumatic lower
extremity amputation rates have sharply declined since 2000 among people aged
75 years and older, women and whites, according to information presented at the
American Diabetes Association 70th Scientific Sessions in
June.
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| Yanfeng Li |
Although follow-up data provided by researchers at the CDC reveals an
increase in the total number of nontraumatic lower extremity amputation
hospitalizations — 54,738 in 1998 to 65,714 in e2006 — the
age-adjusted discharge rate showed a slight decline from 1998 (7.3 per 1,000)
to 1997 (7 per 1,000) and decreased by 7.8% per year until 2006 (3.5 per
1,000).
There was a similar pattern for people aged 74 years and younger, with
declining rates in the mid-90s by about 7% per year.
For people aged 75 years and older, the researchers noted an annual
percentage change (APC) of 15.4% starting in 2000.
When the researchers examined trends by sex, men had higher rates
between 1988 and 2006. The age-adjusted rate started to decrease after 1996 for
men, by an APC of 8.1%, and after 2000 for women, by an APC of 12.1%.
Further, black patients had a higher rate of amputation compared with
white patients; the age-adjusted rate decreased throughout the study period for
blacks (APC: 3.2%), but decreased starting in 2000 for whites (APC: 11.5%).
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| CDC data shows an increase in hospitalizations in 2006 but an age-adjusted discharge rate shows a decline from 1998. |
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| Source: CDC |
Rates of nontraumatic lower extremity amputations were calculated as the
number of hospital discharges with diabetes-related nontraumatic lower
extremity amputations using the National Hospital Discharge Survey and National
Health Interview Survey.
While the study did not examine the reasons for the trends, the
researchers said it may be a result of a reduction in nontraumatic lower
extremity amputation risk factors, care practice improvements and treatment
advances. They also cautioned that the number of amputations may be
underestimated.
Still, “the decline in national nontraumatic lower extremity
amputation rate is encouraging,” Yanfeng Li, MPH, of the division of
diabetes translation, National Center for Chronic Disease Prevention and Health
Promotion, CDC, said at an oral session. “It is consistent with other
improvements in risk factors and outcomes, like peripheral arterial disease and
end-stage renal disease. Effective strategies are needed to reduce disparities
in amputation rate.” — by Jennifer Southall
It is great to see that our older adult population’s healthy life
choices are paying off and this group is living longer and fuller lives than
ever before. It is certainly unfortunate that we are seeing the next generation
coming in to our practices younger than ever, needing diabetic shoes,
prosthetic limbs, and other interventions as a result of this deadly disease.
— Kevin Carroll, MS, CP, FAAOP
Vice
president of prosthetics, Hanger Orthopedic Group Inc. and Practitioner
Advisory Council member, O&P Business News
