Variation in the incidence and proportion at diabetes-related amputations in minorities
Variation in the incidence and proportion at diabetes-related amputations in minorities
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DOI：
10.2337/diacare.19.1.48
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发表时间：
1996-01-01
期刊：
影响因子：
16.2
通讯作者：
Basu, S
中科院分区：
文献类型：
--
作者：
Lavery, LA;Ashry, HR;Basu, S
目的：确定西班牙裔、非裔美国人和非西班牙裔白人中与糖尿病相关的截肢的年龄调整和水平特异性发生率。研究设计和方法：我们使用了加利福尼亚州全州规划和发展办公室的数据库，该数据库确定了1991年该州所有下肢截肢住院病例。截肢级别按照ICD-9-CM代码84.11-84.18定义，分为脚趾、足部、腿部和大腿截肢。结果：1991年，每10000名糖尿病患者中糖尿病相关截肢的年龄调整发生率在非洲裔美国人中为95.25，在非西班牙裔白人中为55.98，在西班牙裔美国人中为44.43。西班牙裔美国人与糖尿病相关的截肢比例（82.7%）高于非洲裔美国人（61.6%）或非西班牙裔白人（56.8%）（P < 0.001）。在糖尿病患者和非糖尿病患者中，非裔美国人的年龄调整后的发病率最高。与非西班牙裔白人和西班牙裔相比，非洲裔美国人的近端截肢率更高（P < 0.001）。与非西班牙裔白人和西班牙裔相比，非洲裔美国人与糖尿病相关的截肢的可能性分别高出1.72倍和2.17倍。结论：与非裔美国人或非西班牙裔白人相比，西班牙裔美国人与糖尿病相关的截肢比例更高。与西班牙裔和非西班牙裔白人相比，非洲裔美国人糖尿病和非糖尿病相关截肢的发生率显著高于近端截肢。一种可能的解释是外周血管疾病在非裔美国人中的患病率更高。应实施公共卫生倡议，这些倡议已被证明可减少与糖尿病有关的下肢截肢的发生率，并应将更多工作重点放在少数群体身上。
OBJECTIVE - To identify the age-adjusted and level-specific incidence of amputations associated with diabetes in Hispanics, African-Americans, and non-Hispanic whites.RESEARCH DESIGN AND METHODS - We used a database from the Office of State-wide Planning and Development in California that identified all hospitalizations for lower-extremity amputations in the state in 1991. Amputation level was defined by ICD-9-CM codes 84.11-84.18 and were categorized as toe, foot, leg, and thigh amputations.RESULTS - The age-adjusted incidence of diabetes-related amputation per 10,000 persons with diabetes in 1991 was 95.25 in African-Americans, 55.98 in non-Hispanic whites, and 44.43 in Hispanics. Hispanics had a higher proportion of amputations (82.7%) associated with diabetes than did African-Americans (61.6%) or non-Hispanic whites (56.8%) (P < 0.001). African-Americans had the highest age adjusted incidence rate for each level in people with and without diabetes. African-Americans underwent more proximal amputations compared with non-Hispanic whites and Hispanics (P < 0.001). Diabetes-related amputations were 1.72 and 2.17 times more likely in African-Americans compared with non-Hispanic whites and Hispanics, respectively.CONCLUSIONS - Hispanics had proportionally more amputations associated with diabetes than did African-Americans or non-Hispanic whites. A significant excess incidence of both diabetes- and non-diabetes-related amputations and proportionally more proximal amputations were identified in African-Americans compared with Hispanics and non-Hispanic whites. A possible explanation could be the higher prevalence of peripheral vascular disease in African-Americans. Public health initiatives, which have been demonstrated to reduce the incidence of diabetes-related lower-extremity amputations, should be implemented, and additional work should focus on minority groups.