Cited by 228Diabetic Foot Ulcer Assessment and ManagementPeripheral Artery Disease ManagementDiabetes, Cardiovascular Risks, and Lipoproteins

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Variation in the recorded incidence of amputation of the lower limb in England

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Holman, N., Young, R. J., Jeffcoate, W. J.·2012·Diabetologia

DOI 10.1007/s00125-012-2468-6

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Abstract

Aims/hypothesis The study aimed to explore the variation in recorded incidence of lower limb amputation in England.Methods The incidences of amputations in adults with and without diabetes were determined from hospital episode statistics over 3 years to 31 March 2010 and compared between the 151 Primary Care Trusts (PCTs) in England.Results There were 34,109 amputations, including 16,693 (48.9%) in people with diabetes. The incidence was 2.51 per 1,000 person-years in people with diabetes and 0.11 per 1,000 person-years in people without (relative diabetes risk 23.3). Incidence varied eightfold across PCTs in people both with diabetes (range 0.64-5.25 per 1,000 person-years) and without (0.03-0.24 per 1,000 person-years). Amputations in people with diabetes varied tenfold--both major (range 0.22-2.20 per 1,000 person-years) and minor (range 0.30-3.25 per 1,000 person-years). The incidences of minor and major amputations were positively correlated both in those with (r = 0.537, p < 0.0005) and without (r = 0.611, p < 0.0005) diabetes. Incidences of amputations were also correlated between people with and without diabetes (total amputations r = 0.433, p < 0.0005; major amputations r = 0.528, p < 0.0005). There was a negative correlation between the incidence of amputation and estimated prevalence of ethnic Asians. No association was found between the PCT incidence of either total amputations and general population prevalence of social deprivation (r = -0.138, p = 0.092) or smoking (r = 0.137, p = 0.096).Conclusions/interpretation Variation in amputation incidence occurs across England. Because of the similarity in amputation variation between people with and without diabetes the variation may reflect generic differences in local healthcare delivery, although racial factors may also contribute.

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Potential inaccuracy in recording the presence of diabetes in people with amputations of the lower limb in hospitals in England. Reply to Ahmed M, Moulik P and Macleod A [letter]
Holman, N., Young, R. J., & Jeffcoate, W. J. (2012) · Diabetologia · doi:10.1007/s00125-012-2736-5
Self-citation
Laser-patterned Composite Carbon Structures for Wound Monitoring Technologies
Phair, J., Brown, A., James, U., McCabe, C., McCartney, B., McGranaghan, S., Monachan, R., Cundell, J. H., & Davis, J. (2013) · Chemistry Letters · doi:10.1246/cl.131008

Authors: Holman, N., Young, R. J., & Jeffcoate, W. J.
Affiliations: Salford Royal NHS Foundation Trust (GB)
Nottingham University Hospitals NHS Trust (GB)
Corresponding author: Jeffcoate, W. J.
ORCID: Holman, N.
Jeffcoate, W. J.
Venue: Diabetologia
Publisher: Springer Science and Business Media LLC
Published: 2012-03-08
Volume: 55
Issue: 7
Pages: 1919-1925
ISSN: 0012-186X (ISSN-L)
1432-0428
DOI: 10.1007/s00125-012-2468-6
OpenAlex: W2115626618
Cited by: 226
References: 18
Citations by year: 2026: 5 · 2025: 6 · 2024: 11 · 2023: 13 · 2022: 12 · 2021: 15 · 2020: 27 · 2019: 20 · 2018: 17 · 2017: 16 · 2016: 19 · 2015: 15 · 2014: 19 · 2013: 20 · 2012: 11
FWCI: 16.67
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Diabetologia (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: lower limb amputation, amputation incidence, diabetes mellitus, regional variation, primary care trusts, social deprivation, smoking, health care delivery
MeSH terms: Adolescent, Adult, Aged, Amputation, Surgical, Analysis of Variance, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, England, Ethnicity, Female, Health Services Accessibility, Humans, Male, Middle Aged, Risk Factors, Incidence, Prevalence, Diabetic Foot, Lower Extremity, Healthcare Disparities, Young Adult

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Variation in the recorded incidence of amputation of the lower limb in England

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