Resurgence of Diabetes-Related Nontraumatic Lower-Extremity Amputation in the Young and Middle-Aged Adult U.S. Population
Autor: | Israel Hora, Deborah B. Rolka, Yanfeng Li, Edward W. Gregg, Ann L. Albright, Linda S. Geiss |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male Research design Pediatrics medicine.medical_specialty Adolescent FOOT Cross-sectional study Endocrinology Diabetes and Metabolism medicine.medical_treatment UNITED-STATES 030209 endocrinology & metabolism Amputation Surgical DISEASE Endocrinology & Metabolism Young Adult 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Diabetes Mellitus Internal Medicine medicine Humans National Health Interview Survey 030212 general & internal medicine Amputation Young adult 11 Medical and Health Sciences Advanced and Specialized Nursing Inpatients Science & Technology business.industry DECLINING RATES Middle Aged medicine.disease Diabetic foot Diabetic Foot United States Hospitalization Cross-Sectional Studies Lower Extremity Female business Life Sciences & Biomedicine Foot (unit) |
Zdroj: | Diabetes Care. 42:50-54 |
ISSN: | 1935-5548 0149-5992 |
Popis: | OBJECTIVE To determine whether declining trends in lower-extremity amputations have continued into the current decade. RESEARCH DESIGN AND METHODS We calculated hospitalization rates for nontraumatic lower-extremity amputation (NLEA) for the years 2000–2015 using nationally representative, serial cross-sectional data from the Nationwide Inpatient Sample on NLEA procedures and from the National Health Interview Survey for estimates of the populations with and without diabetes. RESULTS Age-adjusted NLEA rates per 1,000 adults with diabetes decreased 43% between 2000 (5.38 [95% CI 4.93–5.84]) and 2009 (3.07 [95% CI 2.79–3.34]) (P < 0.001) and then rebounded by 50% between 2009 and 2015 (4.62 [95% CI 4.25–5.00]) (P < 0.001). In contrast, age-adjusted NLEA rates per 1,000 adults without diabetes decreased 22%, from 0.23 per 1,000 (95% CI 0.22–0.25) in 2000 to 0.18 per 1,000 (95% CI 0.17–0.18) in 2015 (P < 0.001). The increase in diabetes-related NLEA rates between 2009 and 2015 was driven by a 62% increase in the rate of minor amputations (from 2.03 [95% CI 1.83–2.22] to 3.29 [95% CI 3.01–3.57], P < 0.001) and a smaller, but also statistically significant, 29% increase in major NLEAs (from 1.04 [95% CI 0.94–1.13] to 1.34 [95% CI 1.22–1.45]). The increases in rates of total, major, and minor amputations were most pronounced in young (age 18–44 years) and middle-aged (age 45–64 years) adults and more pronounced in men than women. CONCLUSIONS After a two-decade decline in lower-extremity amputations, the U.S. may now be experiencing a reversal in the progress, particularly in young and middle-aged adults. |
Databáze: | OpenAIRE |
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