Trends in lower limb amputation incidence in European Union 15+ Countries 1990-2017

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Title: Trends in lower limb amputation incidence in European Union 15+ Countries 1990-2017
Authors: Hughes, W
Goodall, R
Salciccioli, J
Marshall, D
Davies, A
Shalhoub, J
Item Type: Journal Article
Abstract: Objective: Lower extremity amputation (LEA) carries significant mortality, morbidity and health economic burden. In the Westernworld,it most commonly results from complications of peripheral arterial occlusive disease (PAOD) or diabetic foot disease. Incidence of PAOD has declined in Europe,the United States and parts of Australasia.We aimed to assess trends in LEA incidence in European Union (EU15+) countries for the years 1990 to 2017. Design: Observational study using data obtained from the 2017 Global Burden of Disease (GBD) study. Materials: GBD Results Tool: Methods: Age-standardised incidence rates (ASIRs) for LEA (stratified into toe amputation,and LEA proximal to toes) were extracted from the GBD Results Tool for EU15+ countries foreach ofthe years 1990-2017.Trends were analysed using Join point regression analysis. Results: Between 1990 and 2017, variable trends in the incidence of LEA were observedin EU15+ countries. For LEAs proximal to toes, increasing trends were observed in 6 of 19 countries anddecreasing trends in 9 of 19 countries, with 4 countries showing varying trendsbetween sexes. For toe amputation, increasing trends were observed in 8 of 19 countries and decreasing trends in 8 of 19 countries for both sexes, with 3 countries showing varying trendsbetween sexes. Australia hadthe highest ASIRs for both sexes in all LEAs at all time 6 points, with steadily increasing trends. The USA observed the greatest reduction all LEAsin both sexes over the time periodanalysed (LEAs proximal to toes: females -22.93%, males -29.76%; toe amputation: females -29.93%, males -32.67%). The greatest overall increase in incidence was observed in Australia. Conclusions: Variable trends in LEA incidence were observed across EU15+ countries. These trends do not reflect previously observed reductions in incidence of PAO Dover the same time period.
Issue Date: 1-Oct-2020
Date of Acceptance: 16-Apr-2020
DOI: 10.1016/j.ejvs.2020.05.037
ISSN: 1078-5884
Publisher: Elsevier
Start Page: 602
End Page: 612
Journal / Book Title: European Journal of Vascular and Endovascular Surgery
Volume: 60
Issue: 4
Copyright Statement: © 2020 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence
Keywords: Amputation
Peripheral arterial disease
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
Cardiovascular System & Hematology
Publication Status: Published
Online Publication Date: 2020-07-21
Appears in Collections:Department of Surgery and Cancer
National Heart and Lung Institute
Faculty of Medicine

This item is licensed under a Creative Commons License Creative Commons