The Influence of Socio-economic Deprivation on Rates of Major Lower Limb Amputation Secondary to Peripheral Arterial Disease
The Influence of Socio-economic Deprivation on Rates of Major Lower Limb Amputation Secondary to Peripheral Arterial Disease
复制标题
DOI：
10.1016/j.ejvs.2010.03.008
复制
发表时间：
2010-07-01
影响因子：
5.7
通讯作者：
Jayatunga, A. P.
中科院分区：
文献类型：
--
作者：
Ferguson, H. J. M.;Nightingale, P.;Jayatunga, A. P.
目的：调查英国一家地区综合医院集水区内社会经济剥夺与主要下肢截肢率之间的假设联系。设计：对使用OPCS代码识别的下肢截肢患者整理的人口统计学数据库进行分析。资料：本研究纳入2003年1月至2009年1月期间所有经ICD-10编码确认的因周围血管疾病而行下肢截肢的患者。方法：进行了一项病例对照研究，比较2007年主要下肢截肢者与流域人口的多重剥夺指数（IMD）得分。未进行多变量分析。结果：6年期间共327例患者接受了445例下肢截肢。集水区和截肢区IMD评分累积频率的对比图显示，在更贫困的邮编地区，主要截肢的数量更多（P = 0.004）。将流域人口进一步划分为人口匹配的贫困五分位数。两个最贫困的五分位数截肢人数显著增加(OR （95%CI) = 1.654 (1.121 ~ 2.440), P = 0.011）。结论：社会剥夺程度的增加与下肢截肢率呈正相关。如果把最贫困的五分之一人口加起来，截肢率的增幅约为65%。应进一步调查这种不平等现象，并考虑在社会贫困程度较高的地区提供有针对性的护理。2010年欧洲血管外科学会。Elsevier Ltd.出版。版权所有。
Objectives: To investigate a hypothesised link between socio-economic deprivation and rates of major lower limb amputation within the catchment of a district general hospital in the United Kingdom.Design: An analysis of a demographic database collated using patients identified by the OPCS codes for lower limb amputations.Materials: All patients undergoing a lower limb amputation as a result of peripheral vascular disease, as identified by ICD-10 code, between January 2003 and January 2009 were included in the study.Methods: A case-control study was undertaken, comparing the Index of Multiple Deprivation 2007 (IMD) scores of major lower limb amputees, to those of the catchment population. Multivariate analysis was not undertaken.Results: A total of 327 patients underwent 445 lower limb amputations during the 6-year period. A comparative plot of cumulative frequency of IMD score in the catchment and amputation groups indicates greater numbers of major amputations in more deprived postcodes (P = 0.004). The catchment population was further divided into population-matched deprivation quintiles. A significant increase in the number of amputations occurred in the two most deprived quintiles (OR (95%CI) = 1.654 (1.121-2.440), P = 0.011)Conclusions: This study indicates a positive association between increasing social deprivation and rates of lower limb amputation. If the most deprived quintiles are combined, this increase in amputation rates is approximately 65%. This inequity should be further investigated, and consideration given to targeted care within areas of greater social deprivation. 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.