scholarly journals Postservice lower limb amputation in Scottish military veterans

2021 ◽  
pp. bmjmilitary-2020-001720
Author(s):  
Beverly P Bergman ◽  
DF Mackay ◽  
JP Pell
Keyword(s):  
Lower Limb ◽  
Later Life ◽  
Arterial Disease ◽  
Lower Limb Amputation ◽  
Health Study ◽  
Limb Amputation ◽  
Veterans Health ◽  
Cox Proportional Hazard ◽  
Peripheral Arterial

IntroductionRecent attention has focused on veterans who have lost limbs in conflict, but the number of UK veterans who lose limbs to disease is unknown. We used data from the Trends in Scottish Veterans’ Health study to explore postservice lower limb amputation.MethodsWe carried out a retrospective cohort study of 78 000 veterans and 253 000 non-veterans born between 1945 and 1995, matched for age, sex and area of residence. We used survival analysis to examine the risk of amputation in veterans compared with non-veterans, and explored associations with antecedent disease.ResultsWe found no difference between veterans and non-veterans in the risk of lower limb amputation, which was recorded in 145 (0.19%) veterans and 464 (0.18%) non-veterans (Cox proportional hazard ratio (HR) 1.00, 95% CIs 0.82 to 1.20, p=0.961). Peripheral arterial disease was recorded in two-thirds of both veteran and non-veteran amputees, and type 2 diabetes in 41% of veterans and 33% of non-veterans, with a dual diagnosis in 32% of veterans and 26% of non-veterans. Trauma was an infrequent cause of amputation.ConclusionsAlthough in later life veterans are no more likely to lose a limb to disease than non-veterans, the number so affected greatly outweighs those who have lost limbs in conflict. The high public profile of conflict-related limb loss risks eclipsing the needs of veterans with disease-related loss. Support for ageing veterans who have lost limbs due to disease will require planning with the same care as that afforded to the victims of conflict if inequalities are to be avoided.

scholarly journals Epidemiology of major lower limb amputation using routinely collected electronic health data in the UK: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e037053
Author(s):  
Anna Meffen ◽  
Coral J Pepper ◽  
Robert D Sayers ◽  
Laura J Gray
Keyword(s):  
Peripheral Arterial Disease ◽  
Lower Limb ◽  
Arterial Disease ◽  
Health Data ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Cochrane Library ◽  
Electronic Health ◽  
Peripheral Arterial ◽  
The Uk

IntroductionIt is estimated that peripheral arterial disease occurs in one in five people aged over 60 years in the UK. Major lower limb amputation is a debilitating and life-changing potential outcome of peripheral arterial disease. A number of risk factors are involved in the development of the disease including smoking and diabetes. There is debate over the prevalence of major lower limb amputation in the UK with regional variations unexplained. The choice of data source can affect the epidemiological calculations and sources can also differ in the ability to explain variation. This study will aim to estimate the prevalence/incidence/number of major lower limb amputation in the UK. It will also identify sources of routinely collected electronic health data which report the epidemiology of major lower limb amputation in the UK.Methods and analysisA systematic search of peer-reviewed journals will be conducted in Medline, Excerpta Medica database, Cumulative Index of Nursing and Allied Health Literature, Allied and Complementary Medicine Database, The Cochrane Library and Scopus. A grey literature search for government and parliament publications, conference abstracts, theses and unpublished articles will be performed. Articles will be screened against the inclusion/exclusion criteria and data extracted using a pretested extraction form by two independent reviewers. Prevalence, incidence or number of cases (depending on data reported) will be extracted. Disagreements will be resolved by discussion. Data synthesis will be performed either as a narrative summary or by meta-analysis. Heterogeneity will be assessed using the I2 statistic. If heterogeneity is low-moderate, pooled estimates will be calculated using random-effects models. If possible, meta-regression for time trends in the incidence of major lower limb amputation will be performed along with subgroup analysis, primarily in regional variation.Ethics and disseminationEthics approval is not required for this study as study data are anonymised and available in the public domain. Dissemination will be by publication in a peer reviewed journal and by appropriate conference presentation.PROSPERO registration numberCRD42020165592

scholarly journals Lower Limb Amputation Rates in Germany

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 101
Author(s):  
Nike Walter ◽  
Volker Alt ◽  
Markus Rupp
Keyword(s):  
Lower Extremity ◽  
Lower Limb ◽  
Arterial Disease ◽  
Lower Extremity Amputation ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Amputation Level ◽  
Patient Optimization ◽  
Peripheral Arterial ◽  
Extremity Amputation

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.

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