Estimating the prevalence of limb loss in the United States: 2005 to 2050
Estimating the prevalence of limb loss in the United States: 2005 to 2050
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DOI：
10.1016/j.apmr.2007.11.005
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发表时间：
2008-03-01
影响因子：
4.3
通讯作者：
Brookmeyer, Ron
中科院分区：
文献类型：
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作者：
Ziegler-Graham, Kathryn;MacKenzie, Ellen J.;Brookmeyer, Ron
目的：估计美国目前肢体缺失的患病率，并预测到2050年的未来患病率。设计：估计值采用年龄、性别和种族特异性截肢发生率结合年龄。关于死亡率的性别和种族特定假设。发病率来源于1988年至1999年医疗保健成本和利用项目的全国住院患者样本，对因血管疾病截肢的患者进行了再截肢的可能性校正。假设发病率随时间保持不变，并将其应用于历史死亡率和人口数据沿着相对风险、未来死亡率和未来人口预测的最佳估计值。为了研究我们的预测对发病率增加或减少的敏感性，我们根据血管障碍条件下截肢发病率增加或减少10%或25%的假设，开发了与血管障碍条件相关的肢体丧失的替代估计集。设置：美国社区，非联邦，短期医院。参与者：出院时的上肢或下肢截肢手术代码或创伤性截肢诊断代码。干预措施：不适用。主要结果测量：2005年按年龄、性别、种族、病因学和程度划分的肢体丧失患病率以及对2050年的预测。结果：2005年，有160万人生活在肢体丧失中。在这些受试者中，42%为非白人，38%的受试者继发于血管障碍性疾病伴糖尿病的截肢。据预测，到2050年，失去肢体的人数将增加一倍以上，达到360万人。如果继发于血管障碍疾病的发病率可以降低10%，这个数字将减少225,000。结论：目前每190个美国人中就有一个人生活在肢体缺失的情况下。如果不加以控制，到2050年这一数字可能会翻一番。
Objective: To estimate the current prevalence of limb loss in the United States and project the future prevalence to the year 2050.Design: Estimates were constructed using age-, sex-, and race-specific incidence rates for amputation combined with age-. sex-, and race-specific assumptions about mortality. Incidence rates were derived from the 1988 to 1999 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project, corrected for the likelihood of reamputation among those undergoing amputation for vascular disease. Incidence rates were assumed to remain constant over time and applied to historic mortality and population data along with the best available estimates of relative risk, future mortality, and future population projections. To investigate the sensitivity of our projections to increasing or decreasing incidence, we developed alternative sets of estimates of limb loss related to dys-vascular conditions based on assumptions of a 10% or 25% increase or decrease in incidence of amputations for these conditions.Setting: Community, nonfederal, short-term hospitals in the United States.Participants: Persons who were discharged from a hospital with a procedure code for upper-limb or lower-limb amputation or diagnosis code of traumatic amputation.Interventions: Not applicable.Main Outcome Measures: Prevalence of limb loss by age, sex, race, etiology, and level in 2005 and projections to the year 2050.Results: In the year 2005, 1.6 million persons were living with the loss of a limb. Of these subjects, 42% were nonwhite and 38% had an amputation secondary to dysvascular disease with a comorbid diagnosis of diabetes mellitus. It is projected that the number of people living with the loss of a limb will more than double by the year 2050 to 3.6 million. If incidence rates secondary to dysvascular disease can be reduced by 10%, this number would be lowered by 225,000.Conclusions: One in 190 Americans is currently living with the loss of a limb. Unchecked, this number may double by the year 2050.