Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 3 , Pages 422-429 , March 2008

Estimating the Prevalence of Limb Loss in the United States: 2005 to 2050

  • Kathryn Ziegler-Graham, PhD

      Affiliations

    • Department of Mathematics, Statistics and Computer Science, St. Olaf College, Northfield, MN
    • ,
  • Ellen J. MacKenzie, PhD

      Affiliations

    • Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
    • Corresponding Author InformationReprint requests to Ellen J. MacKenzie, PhD, Dept of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 624 N Broadway, Rm 482, Baltimore, MD 21205
    • ,
  • Patti L. Ephraim, MPH

      Affiliations

    • Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
    • ,
  • Thomas G. Travison, PhD

      Affiliations

    • New England Research Institutes, Waltham, MA
    • ,
  • Ron Brookmeyer, PhD

      Affiliations

    • Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

References 

  1. Owings M, Kozak L. Ambulatory and inpatient procedures in the United States, 1996. Vital Health Stat 13. 1998;139:1–119
  2. Dillingham T, Pezzin L, MacKenzie E. Limb amputation and limb deficiencies: epidemiology and recent trends in the United States. South Med J. 2002;95:875–883
  3. Wrobel J, Mayfield J, Reiber G. Geographic variation of lower-extremity major amputation in individuals with and without diabetes in the Medicare population. Diabetes Care. 2001;24:860–864
  4. Lavery L, Ashry H, van Houtum W, Pugh J, Harkless L, Basu S. Variation in the incidence and proportion of diabetes-related amputations in minorities. Diabetes Care. 1996;19:48–52
  5. Lavery L, van Houtum W, Ashry H, Armstrong D, Pugh J. Diabetes-related lower-extremity amputations disproportionately affect Blacks and Mexican Americans. South Med J. 1999;92:593–599
  6. van Houtum W, Lavery L. Regional variation in the incidence of diabetes-related amputations in The Netherlands. Diabetes Res Clin Pract. 1996;31:125–132
  7. van Houtum W, Lavery L, Harkless L. The impact of diabetes-related lower-extremity amputations in The Netherlands. J Diabetes Complications. 1996;10:325–330
  8. van Houtum W, Lavery L. Outcomes associated with diabetes-related amputations in The Netherlands and in the state of California, USA. J Intern Med. 1996;240:227–231
  9. van Houtum W, Lavery L. Methodological issues affect variability in reported incidence of lower extremity amputations due to diabetes. Diabetes Res Clin Pract. 1997;38:177–183
  10. Van Buskirk A, Barta P, Schlossbach N. Lower extremity amputations in New Jersey. N J Med. 1994;91:260–263
  11. Valway S, Linkins R, Gohdes D. Epidemiology of lower-extremity amputations in the Indian Health Service, 1982-1987. Diabetes Care. 1993;16:349–353
  12. Wetterhall S, Olson D, DeStefano F, et al. Trends in diabetes and diabetic complications, 1980-1987. Diabetes Care. 1992;15:960–967
  13. Centers for Disease Control (CDC). Lower extremity amputations among persons with diabetes mellitus—Washington, 1988. MMWR Morb Mort Wkly Rep. 1991;40:737–739
  14. Miller A, Van Buskirk A, Verhoek-Oftedahl W, Miller E. Diabetes-related lower extremity amputations in New Jersey, 1979 to 1981. J Med Soc N J. 1985;82:723–726
  15. Most R, Sinnock P. The epidemiology of lower extremity amputations in diabetic individuals. Diabetes Care. 1983;6:87–91
  16. Dillingham T, Pezzin L, MacKenzie E. Racial differences in the incidence of limb loss secondary to peripheral vascular disease: a population-based study. Arch Phys Med Rehabil. 2002;83:1252–1257
  17. Feinglass J, Brown J, LoSasso A, et al. Rates of lower-extremity amputation and arterial reconstruction in the United States, 1979 to 1996. Am J Public Health. 1999;89:1222–1227
  18. Feinglass J, Kaushik S, Handel D, Kosifas A, Martin G, Pearce W. Peripheral bypass surgery and amputation: northern Illinois demographics, 1993 to 1997. Arch Surg. 2000;135:75–80
  19. Huber T, Wang J, Wheeler K, et al. Impact of race on the treatment for peripheral arterial occlusive disease. J Vasc Surg. 1999;30:417–425
  20. Tunis S, Bass E, Steinberg E. The use of angioplasty, bypass surgery, and amputation in the management of peripheral vascular disease. N Engl J Med. 1991;325:556–562
  21. Tunis S, Bass E, Klag M, Steinberg E. Variation in utilization of procedures for treatment of peripheral arterial disease (A look at patient characteristics). Arch Intern Med. 1993;153:991–998
  22. Dillingham T, Pezzin L, MacKenzie E. Incidence, acute care length of stay, and discharge to rehabilitation of traumatic amputee patients: an epidemiologic study. Arch Phys Med Rehabil. 1998;79:279–287
  23. Boyle D, Parker D, Larson C, Pessoa-Brandao L. Nature, incidence, and cause of work-related amputations in Minnesota. Am J Ind Med. 2000;37:551–557
  24. Sorock G, Smith E, Hall N. Hospitalized occupational finger amputations, New Jersey, 1985-1986. Am J Ind Med. 1993;23:439–447
  25. Ebskov L. Major amputation for malignant melanoma: an epidemiological study. J Surg Oncol. 1993;52:89–91
  26. Centers for Disease Control and Prevention/National Center for Health StatisticsAdams P, Hendershot G, Marano M. Current estimates from the National Health Interview Survey, 1996. Vital Health Stat 10. 1999;200:1–203
  27. Brookmeyer R, Gray S. Methods for projecting the incidence and prevalence of chronic diseases in ageing populations: application to Alzheimer’s disease. Stat Med. 2000;19:1481–1493
  28. Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health. Forecasting the global burden of Alzheimer’s disease. http://www.biostat.jhsph.edu/project/globalAD/index.htmAccessed July 20, 2007
  29. Dillingham T, Pezzin L, MacKenzie E. Incidence, acute care length of stay, and discharge to rehabilitation of traumatic amputee patients: an epidemiologic study. Arch Phys Med Rehabil. 1998;79:279–287
  30. Izumi Y, Satterfield K, Lee S, Harkless LB. Risk of reamputation in diabetic patients stratified by limb and level of amputation. Diabetes Care. 2006;29:566–570
  31. Sambamoorthi U, Tseng CL, Rajan M, Anjali T, Findley PA, Pogach L. Initial nontraumatic lower-extremity amputations among veterans with diabetes. Med Care. 2006;44:779–787
  32. Dillingham TR, Pezzin LE, Shore AD. Reamputation, mortality and health care costs among persons with dysvascular lower-limb amputations. Arch Phys Med Rehabil. 2005;86:480–486
  33. U.S. Census Bureau. Population estimates. http://www.census.gov/popest/estimates.php2000;Accessed Oct 30, 2007
  34. Hastie TJ, Tibshirani RJ. Generalized additive models. In: London: Chapman & Hall; 1990;p. 15
  35. U.S. Census Bureau. Population projections. http://www.census.gov/population/www/projections/popproj.html2000;Accessed Oct 30, 2007
  36. National Center for Health Statistics. Vital statistics of the United States, 1955-1958. Vol 1 Washington (DC): U.S. Department of Health, Education, and Welfare, Public Health Service; 1957-1960;
  37. National Center for Health Statistics. Vital statistics of the United States, 1959. Vol I Washington (DC): U.S. Department of Health, Education, and Welfare, Public Health Service; 1962;
  38. National Center for Health Statistics. Vital statistics of the United States, 1960-1998. Vol 1 Washington (DC): U.S. Department of Health, Education, and Welfare, Public Health Service; 1963-2001;
  39. U.S. Census Bureau. Historical statistics for the United States, colonial times to 1970. Pt 1 Washington (DC): Population Div, U.S. Census Bureau; 1975;
  40. Hoyert D, Arias E, Smith B, Murphy S, Kochanek KD. Deaths: final data for 1999. Natl Vital Stat Rep. 2001;49(8):1–113
  41. Surveillance, Epidemiology, and End Results (SEER) Program public-use data (1992-2002). Rockville: National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch; 2004;Available at: http://www.seer.cancer.gov/canques/. Accessed Oct 30, 2007
  42. Criqui M. Peripheral arterial disease—epidemiological aspects. Vasc Med. 2001;6(3 Suppl):3–7
  43. Gu K, Cowie C, Harris M. Mortality in adults with and without diabetes in a national cohort of the U.S. population, 1971-1993. Diabetes Care. 1998;21:1138–1145
  44. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes. Diabetes Care. 2004;27:1047–1053
  45. Flegal K, Carroll M, Ogden C, Johnson C. Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002;288:1723–1727
  46. Mokdad A, Bowman B, Ford E, Vinicor F, Marks J, Koplan J. The continuing epidemics of obesity and diabetes in the United States. JAMA. 2001;286:1195–1200
  47. Gregg E, Cadwell B, Cheng Y, et al. Trends in the prevalence and ratio of diagnosed to undiagnosed diabetes according to obesity levels in the U.S. Diabetes Care. 2004;27:2806–2812
  48. Manson J, Nathan D, Krolewski A, Stampfer M, Willett W, Hennedkens C. A prospective study of exercise and incidence of diabetes among US male physicians. JAMA. 1992;268:63–67
  49. Hu F, Manson J, Stampfer M, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med. 2001;345:790–797
  50. Gujral J, McNally P, O’Malley B, Burden A. Ethnic differences in the incidence of lower extremity amputation secondary to diabetes mellitus. Diabet Med. 1993;10:271–274
  51. Wachtel M. Family poverty accounts for difference in lower-extremity amputation rates of minorities 50 years old or more with diabetes. J Natl Med Assoc. 2005;97:334–338
  52. Rucker-Whitaker C, Feinglass J, Pearce W. Explaining racial variation in lower extremity amputation: a 5-year retrospective claims data and medical record review at an urban teaching hospital. Arch Surg. 2003;138:1347–1351
  53. Feinglass J, Rucker-Whitaker C, Lindquist L, McCarthy W, Pearce W. Racial differences in primary and repeat lower extremity amputation: results from a multihospital study. J Vasc Surg. 2005;41:823–829
  54. U.S. Department of Health and Human Services. Healthy people 2010: understanding and improving health. 2nd ed.. Washington (DC): U.S. Government Printing Office; 2000;
  55. Mayfield J, Reiber G, Nelson R, Greene T. Do foot examinations reduce the risk of diabetic amputation?. J Fam Pract. 2000;49:499–504
  56. Larsson J, Apelqvist J, Agardh C, Stenstrom A. Decreasing incidence of major amputation in diabetic patients: a consequence of a multidisciplinary foot care team approach?. Diabet Med. 1995;12:770–776
  57. Rith-Najarian S, Reiber G. Prevention of foot problems in persons with diabetes. J Fam Pract. 2000;49(11 Suppl):S30–S39
  58. Strine T, Okoro C, Chapman D, Beckles G, Balluz L, Mokdad A. The impact of formal diabetes education on the preventive health practices and behaviors of persons with type 2 diabetes. Prev Med. 2005;41:79–84
  59. Reiber G, Boyko E, Smith D. Lower extremity foot ulcers and amputations in diabetes. In:  Harris M,  Cowie C,  Stern M,  Boyko E,  Reiber G,  Bennett P editor. Diabetes in America. 2nd ed.. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995;p. 409–428NIH Publication No. 95-1468
  60. Armstrong D, Lavery L, Harkless L, van Houtum W. Amputation and reamputation of the diabetic foot. J Am Podiatr Med Assoc. 1997;87:255–259
  61. Larsson J, Agardh C, Apelqvist J, Stenstrom A. Long term prognosis after healed amputations in patients with diabetes. May Clin Orthop Relat Res. 1998;350:149–158
  62. Pecoraro R, Reiber G, Burgess E. Pathways to diabetic limb amputation: basis for prevention. Diabetes Care. 1990;13:513–521
  63. Mayfield JA, Reiber GE, Maynard C, Czerniecki JM, Caps MT, Sangeorzan BJ. Trends in lower limb amputation in the Veterans Health Administration, 1989-1998. J Rehabil Res Dev. 2000;37:23–30
  64. Fischer H. CRS report to Congress. U.S. military casualty statistics: Operation Iraqi Freedom and Operation Enduring Freedom. http://www.fas.org/sgp/crs/natsec/RS22452.pdfAccessed July 26, 2007
  65. Blustein J. The reliability of racial classifications in hospital discharge abstract data. Am J Public Health. 1994;84:1018–1021
  66. Boehmer U, Kressin N, Berlowitz D, Christiansen C, Kazis L, Jones J. Self-reported vs administrative race/ethnicity data and study results. Am J Public Health. 2002;92:1471–1472
  67. Kressin N, Chang B, Hendricks A, Kazis L. Agreement between administrative data and patients’ self-reports of race/ethnicity. Am J Public Health. 2003;93:1734–1739

 Supported by the U.S. Centers for Disease Control and Prevention (grant no. R04/CCU322981-02).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(07)01748-0

doi: 10.1016/j.apmr.2007.11.005

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 3 , Pages 422-429 , March 2008

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