Original Article

Diabetes-related Lower Extremity Amputation Rates Fall Significantly in South Carolina

Authors: William K. Mountford, MS, Jeremy B. Soule, MD, Daniel T. Lackland, DrPH, Stuart R. Lipsitz, ScD, John A. Colwell, MD, PhD


Background: The aims of this study are to compare the diabetes-related lower extremity amputation (LEA) rate trend in South Carolina (SC) to that of the United States (US) and to determine changes in LEA rates in SC according to age, race, gender, and amputation site.

Methods: National Hospital Discharge Survey (NHDS) and SC hospital discharge data for 1996 to 2002 were analyzed. ICD-9-CM codes identified all diabetic patients and occurrences of LEA. Linear regression was used to compare the LEA rate trends between SC and the US.

Results: LEA rates are decreasing throughout the study period. The slope is greater in SC compared with US (US slope = −0.00082; SC slope = −0.0015; P = 0.002), signifying a decrease in LEA rates of 1.5/1000 per year in SC and 0.8/1000 per year in the US. Furthermore, LEA rate decreases in SC are significant throughout all ages, races, genders, and amputation levels.

Conclusions: Diabetes-related LEA rates are decreasing in SC more rapidly than in the US. Ongoing community-level education may be assisting in the favorable trends.

Key Points

* Diabetes-related amputation rates are decreasing at a more rapid rate in South Carolina (SC) compared to the United States (US).

* The SC LEA rate decreases are seen for all race-gender and age groups.

* The number of amputation procedures in hospitals are also decreasing at all levels for people with diabetes in SC.

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