Amputation Rates Down, Especially For Seniors...

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.

Although follow-up data provided by researchers at the CDC reveal an increase in the total number of nontraumatic lower extremity amputation hospitalizations — 54,738 in 1998 to 65,714 in 2006 — 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; P<.01).

There was a similar pattern for people aged 74 years and younger, with declining rates in the mid-90s by about 7% per year (P<.01).

For people aged 75 years and older, the researchers noted a steep decline starting in 2000 (annual percentage change (APC): 15.4%).

When the researchers examined trends by sex, men had higher rates between 1988 and 2006 (P<.01). 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% (P<.01 for both).

Further, black patients had a higher rate of amputations 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%; P <.01 for both).

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.”

Source: Endocrine Today