The Effect of Limb Salvage Efforts in Different Age Groups: Relationships Between Major and Minor Amputations

Authors

Wenye Song, University of Texas Medical Branch
Javier La Fontaine, The University of Texas Rio Grande Valley
Naohiro Shibuya, The University of Texas Rio Grande ValleyFollow
John Prochaska, University of Texas Medical Branch
Daniel C. Jupiter, University of Texas Medical Branch

Document Type

Article

Publication Date

6-2024

Abstract

“Limb salvage” efforts, such as performing minor amputations before infections spread proximally from the foot to decrease major lower extremity amputation, are an important part of healthcare today. It is unclear whether these efforts are preventing the number of major amputations and improving patients’ quality of life and the cost-effectiveness of the U.S. healthcare system. Rates of non-traumatic lower extremity amputation (NLEA) among patients with diabetes decreased in the early 2000s but rebounded in the 2010s. We analyzed the proportion of major amputations and differences in amputation rates between age groups in Texas. Patient data was extracted from the Texas Hospital Discharge Data Public Use Data File. Population estimates were obtained from the Texas Population Estimates Program from 2011-2015 and from intercensal estimates provided by the U.S. Census Bureau from 2006-2010. Raw numbers of minor, major, and all NLEA surgeries and the ratio of major amputations to total amputations per year were reported for each age group. Poisson regression and Joinpoint analyses were performed to capture these changes in trends. Rates of amputations increased, with significant decreasing relative prevalence of major amputations. Patients aged 45-64 with diabetes are likely driving these increases. Rates of lower extremity amputation in patients with diabetes increased from 2009-2015. This holds for all and minor amputations. In contrast, the ratio of major to all amputations decreased from 2010. Utilization of major and minor amputation differs between age groups, remaining stable in the youngest subjects, with minor amputation rates increasing in those aged 45-64.

Level of Clinical Evidence

Level 3, Prognostic

Comments

Original published version available at https://doi.org/10.1053/j.jfas.2024.01.010

Recommended Citation

Song, W., La Fontaine, J., Shibuya, N., Prochaska, J., & Jupiter, D. C. (2024). The Effect of Limb Salvage Efforts in Different Age Groups: Relationships Between Major and Minor Amputations. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 63(3), 380–385. https://doi.org/10.1053/j.jfas.2024.01.010

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Publication Title

The Journal of Foot and Ankle Surgery

Academic Level

faculty

DOI

10.1053/j.jfas.2024.01.010