Epidemiology of Limb Loss

Abstract

Synopsis In 2005, 1.6 million people were estimated to be living with limb loss and by 2050, the rate is expected to double to 3.6 million in the United States. (1) Past data has shown the rates of dysvascular amputations were on the rise. However, recent studies looking at single diseases of Peripheral Arterial Disease (PAD) and Diabetes Mellitus commonly associated with dysvascular related amputations show that these conditions are now on the decline. We believe that it may not be a single disease process but rather the cumulative illness burden that is leading to amputations. In addition to etiology, age, gender, and race continue to play a role in limb loss. Limb loss is more common among older individuals, men, and non-whites. Trauma and cancer related amputations are on the decline and congenital amputations are unchanged in rates.

Incidence of lower limb amputation in Canada

“…5 Unlike earlier studies that have shown an increase in the incidence of LLA in Western countries, 6 the most recent studies have reported a decline or no change in the rates. [7][8][9] The LLA incidence data are unknown for Canada. As a result, incidence rates from other countries, particularly the United States, are commonly used to support health care planning and research initiatives.…”

Comment on Yang et al. Association of Statin Use and Reduced Risk of Lower-Extremity Amputation Among Patients With Diabetes: A Nationwide Population-Based Cohort Observation. Diabetes Care 2016;39:e54–e55

“…With this in mind, we were pleased to read the study by Yang et al (4) [3], unknown [1]), we found a trend associating their use with DFU healing (regression coefficient 20.148, P 5 0.057).…”

“…It is estimated that 2 million Americans, two-thirds of whom have diabetes mellitus (DM), are currently living with a limb amputation (1). Patients with DM are at significant risk for limb amputation, as one in four will develop a diabetic foot ulcer (DFU) over their lifetime and nearly one in six will require amputation (2).…”

“…Patients with DM are at significant risk for limb amputation, as one in four will develop a diabetic foot ulcer (DFU) over their lifetime and nearly one in six will require amputation (2). In 2009, U.S. hospital costs due to amputation exceeded $8.3 billion, and annual U.S. DFU treatment costs are approaching $13 billion (1)(2)(3).…”

Fatores associados ao óbito em pacientes submetidos à “Onda Vermelha”: ênfase na toracotomia de emergência

“…5 Independentemente do tipo, quando há comprometimento vascular, pode haver trombose e isquemia, com consequente interrupção do fluxo sanguíneo aos órgãos ou extremidades, ou hemorragia, que pode ser igualmente fatal, ambos evoluindo eventualmente para o choque, que pode ser cardiogênico, obstrutivo, distributivo ou hipovolêmio. 3,7,8 Em resposta principalmente ao trauma vascular, o protocolo "Onda Vermelha" foi iniciado em novembro de 2004, em Belo Horizonte. Consiste em uma adaptação da manobra de Mattox, 9 com a realização da toracotomia ou laparotomia, como abordagem direta ao foco do sangramento, empregando um conjunto de táticas médicas e administrativas, com o objetivo de realizar, em centro cirúrgico, o atendimento à vítima grave, cuja condição implique morte iminente.…”