Article

Contemporary literature reports that the incidence of lower limb
amputation has declined in many countries. This impression may be misleading
given that many publications only describe the incidence of lower limb
amputations above the ankle and fail to include lower limb amputations below the
ankle. OBJECTIVES: To describe trends in the incidence of different levels of
lower limb amputation in Australian hospitals over a 10-year period. STUDY DESIGN: Descriptive. METHOD: Data describing the age-standardised incidence of
lower limb amputation were calculated from the Australian National Hospital
Morbidity database and analysed for trends over a 10-year period. RESULTS: The
age-standardised incidence of lower limb amputation remained unchanged over time
(p = 0.786). A significant increase in the incidence of partial foot amputations
(p = 0.001) and a decline in the incidence of transfemoral (p = 0.00) and
transtibial amputations (p = 0.00) were observed. There are now three lower limb
amputations below the ankle for every lower limb amputation above the ankle.
CONCLUSION: While the age-standardised incidence of all lower limb amputation has
not changed, a shift in the proportion of lower limb amputations above the ankle
and lower limb amputations below the ankle may be the result of improved
management of precursor disease that makes partial foot amputation a more
commonly utilised alternative to lower limb amputations above the ankle. Clinical relevance. This article highlights that although the incidence of lower limb
amputation has remained steady, the proportion of amputations above the ankle and
below the ankle has changed dramatically over the last decade. This has
implications for how we judge the success of efforts to reduce the incidence of
lower limb amputation and the services required to meet the increasing proportion
of persons with amputation below the ankle.

Langue : ANGLAIS