Epidemiological study of lower limb amputation in England between 2003 and 2008
Epidemiological study of lower limb amputation in England between 2003 and 2008
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DOI：
10.1002/bjs.7092
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发表时间：
2010-09-10
影响因子：
9.6
通讯作者：
Holt, P. J. E.
中科院分区：
文献类型：
--
作者：
Moxey, P. W.;Hofman, D.;Holt, P. J. E.
背景资料：本研究的目的是调查下肢截肢在英格兰的患病率，以建立相关的死亡率，并确定与糖尿病和以前的revascularization.Methods的关系：2003年和2008年之间的下肢截肢的所有患者的数据从医院事件统计数据库中提取。结果：大截肢率为5.1/10万，5年来没有变化。腿部大截肢的死亡率为16.8%（膝上截肢为21.4%，膝下截肢为11.6%）;随着时间的推移，死亡率显著下降（P < 0.001）。英国不同地区截肢率、死亡率及膝下截肢与膝上截肢的比例有显著性差异（P < 0.001）。在接受大截肢手术的病人中，约39.4%患有糖尿病。截肢前血运重建的几率随着时间的推移显着增加（P = 0.035）。结论：2003年至2008年期间，英国的大截肢率和小截肢率是稳定的，伴随着围手术期死亡率的显着降低。截肢率、死亡率和膝下与膝上截肢比率存在显著的地理差异。
Background: The purpose of this study was to investigate the prevalence of lower extremity amputation in England, to establish the associated mortality, and to determine the relationship with diabetes mellitus and previous revascularization.Methods: Data on all patients who had a lower extremity amputation between 2003 and 2008 were extracted from the Hospital Episode Statistics database. Risk adjustment and linear regression were used to compare the data.Results: The major amputation rate was 5.1 per 100 000 population and did not change over the 5 years. The mortality rate for major leg amputation was 16.8 per cent (21.4 per cent for above-knee and 11.6 per cent for below-knee amputation); this decreased significantly over time (P < 0.001). There was a significant difference in amputation rate, mortality rate and the below-knee : above-knee amputation ratio between different areas of England (P < 0.001). Some 39.4 per cent of patients who underwent major amputation had diabetes mellitus. The odds of revascularization before amputation increased significantly over time (P = 0.035).Conclusion: Major and minor amputation rates were stable across England between 2003 and 2008, accompanied by a significant reduction in perioperative mortality. There were significant geographical variations in amputation rates, mortality rates and the below-knee : above-knee amputation ratio.