Abstract
Background and Objectives: The current epidemiology of lower limb amputations is unknown. Therefore, the purpose of this study was to determine (1) lower extremity amputation rates as a function of age, gender, and amputation level between 2015 and 2019, (2) main diagnoses indicating amputation, (3) revision rates after lower extremity amputation. Materials and Methods: Lower extremity amputation rates were quantified based on annual Operation and Procedure Classification System (OPS) and International Classifications of Disease (ICD)-10 codes from all German medical institutions between 2015 through 2019, provided by the Federal Statistical Office of Germany (Destatis). Results: In 2019, 62,016 performed amputations were registered in Germany. Out of these 16,452 procedures (26.5%) were major amputations and 45,564 patients (73.5%) underwent minor amputations. Compared to 2015, the incidence of major amputations decreased by 7.3% to 24.2/100,000 inhabitants, whereas the incidence of minor amputation increased by 11.8% to 67.1/100,000 inhabitants. Highest incidence was found for male patients aged 80–89 years. Patients were mainly diagnosed with peripheral arterial disease (50.7% for major and 35.7% for minor amputations) and diabetes mellitus (18.5% for major and 44.2% for minor amputations). Conclusions: Lower limb amputations remain a serious problem. Further efforts in terms of multidisciplinary team approaches and patient optimization strategies are required to reduce lower limb amputation rates.
Highlights
Lower limb amputations are usually performed to excise necrotic tissue and can have multiple causes such as diabetes mellitus (DM), peripheral arterial disease (PAD), bone and joint infections, peripheral neuropathy, trauma, or malignancy [1]
The majority of patients who underwent major amputations was diagnosed with PAD (50.7%), whereas 18.5% were diagnosed with DM (Figure 2)
Santosa et al used data provided by Destatis to determine amputation rates in Germany for the years 2005–2010 estimating a decrease of 4.8/100,000 inhabitants for major amputations and an increase of 5.5/100,000 inhabitants for minor amputations [16]
Summary
Lower limb amputations are usually performed to excise necrotic tissue and can have multiple causes such as diabetes mellitus (DM), peripheral arterial disease (PAD), bone and joint infections, peripheral neuropathy, trauma, or malignancy [1]. Cases of PAD have been heightening, likely due to the demographic trend of aging [6]. Both diagnoses increase the risk for amputations [7]. Results: In 2019, 62,016 performed amputations were registered in Germany Out of these 16,452 procedures (26.5%) were major amputations and 45,564 patients (73.5%) underwent minor amputations. Patients were mainly diagnosed with peripheral arterial disease (50.7% for major and 35.7% for minor amputations) and diabetes mellitus (18.5% for major and 44.2% for minor amputations). Further efforts in terms of multidisciplinary team approaches and patient optimization strategies are required to reduce lower limb amputation rates
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