Abstract
AimsTo describe trends in the incidence of non-traumatic amputations among people with and without diabetes and estimate the relative risk of an individual with diabetes undergoing a lower extremity amputation compared to an individual without diabetes in the Republic of Ireland.MethodsAll adults who underwent a nontraumatic amputation during 2005 to 2009 were identified using HIPE (Hospital In-patient Enquiry) data. Participants were classified as having diabetes or not having diabetes. Incidence rates were calculated using the number of discharges for diabetes and non-diabetes related lower extremity amputations as the numerator and estimates of the resident population with and without diabetes as the denominator. Age-adjusted incidence rates were used for trend analysis.ResultsTotal diabetes-related amputation rates increased non-significantly during the study period; 144.2 in 2005 to 175.7 in 2009 per 100,000 people with diabetes (p = 0.11). Total non-diabetes related amputation rates dropped non-significantly from 12.0 in 2005 to 9.2 in 2009 per 100,000 people without diabetes (p = 0.16). An individual with diabetes was 22.3 (95% CI 19.1–26.1) times more likely to undergo a nontraumatic amputation than an individual without diabetes in 2005 and this did not change significantly by 2009.DiscussionThis study provides the first national estimate of lower extremity amputation rates in the Republic of Ireland. Diabetes-related amputation rates have remained steady despite an increase in people with diabetes. These estimates provide a base-line and will allow follow-up over time.
Highlights
Diabetic foot disease is a major health problem and Lower Extremity Amputation (LEA) remains a common outcome
The objectives of this study are to determine diabetes-related and non-diabetes related LEA incidence rates and estimate the relative risk of an individual with diabetes undergoing a lower extremity amputation compared to an individual without diabetes in the Republic of Ireland (ROI)
The median length of stay for a LEA in people with diabetes was 24 days; with a total of 60,332 bed days occupied over the 5 year study period
Summary
Diabetic foot disease is a major health problem and Lower Extremity Amputation (LEA) remains a common outcome. The prevalence of diabetes is rising in the Republic of Ireland (ROI), with a projected increase to 5.9% of the population by 2020 [3]. Increased numbers of people with diabetes is expected to lead to an increased burden on the health services. A rise in the number of LEAs in people with diabetes is anticipated [4]. Lower Extremity Amputations are an important indicator of the quality of care of diabetes in a population [5]. Recent data from England (2008) estimated LEA rates of 250 per 100,000 population with diabetes [7]
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