Mayfield J A, Reiber G E, Maynard C, Czerniecki J M, Caps M T, Sangeorzan B J
Center of Excellence in Amputation, Prosthetics, and Limb Loss Prevention, Rehabilitation Research and Development, Puget Sound Health Care System, Seattle, WA 98108, USA.
J Rehabil Res Dev. 2000 Jan-Feb;37(1):23-30.
To assess trends in lower limb amputation performed in Veterans Health Administration (VHA) facilities.
All lower limb amputations recorded in the Patient Treatment File for 1989-1998 were analyzed using the hospital discharge as the unit of analysis. Age-specific rates were calculated using the VHA user-population as the denominator. Frequency tables and linear, logistic, and Poisson regression were used respectively to assess trends in amputation numbers, reoperation rates, and age-specific amputation rates.
Between 1989-1998, there were 60,324 discharges with amputation in VHA facilities. Over 99.9% of these were in men and constitute 10 percent of all US male amputations. The major indications were diabetes (62.9%) and peripheral vascular disease alone (23.6%). The age-specific rates of major amputation in the VHA are higher than US rates of major amputation. VHA rates of major and minor amputation declined an average of 5% each year, while the number of diabetes-associated amputations remained the same.
The number and age-specific rates of amputations decreased over 10 years despite an increase in the number of veterans using VHA care.
评估退伍军人健康管理局（VHA）设施中进行的下肢截肢手术趋势。
以医院出院情况作为分析单位，对1989 - 1998年患者治疗档案中记录的所有下肢截肢手术进行分析。以VHA用户群体作为分母计算特定年龄发病率。分别使用频率表、线性回归、逻辑回归和泊松回归来评估截肢手术数量、再次手术率和特定年龄截肢率的趋势。
1989 - 1998年间，VHA设施中有60324例截肢患者出院。其中超过99.9%为男性，占美国所有男性截肢患者的10%。主要指征为糖尿病（62.9%）和单纯外周血管疾病（23.6%）。VHA中主要截肢的特定年龄发病率高于美国主要截肢发病率。VHA中主要和次要截肢率平均每年下降5%，而与糖尿病相关的截肢手术数量保持不变。
尽管使用VHA护理的退伍军人数量有所增加，但截肢手术的数量和特定年龄发病率在10年期间有所下降。
