Department of Rehabilitation, Montefiore Medical Center, Bronx, NY, USA.
Department of Physical Medicine and Rehabilitation, Metropolitan Hospital, New York, NY, USA.
Int J Equity Health. 2024 Sep 3;23(1):178. doi: 10.1186/s12939-024-02264-7.
Lower extremity amputations (LEAs) significantly contribute to mortality and morbidity, often resulting from peripheral artery disease and diabetes mellitus (DM). Traumatic injuries also account for many LEAs. Despite the global burden, the epidemiology of LEAs, particularly in the Middle East and North Africa (MENA) region, remains underexplored. This study utilizes the Global Burden of Disease (GBD) dataset to analyze temporal trends in LEAs in the MENA region from 1990 to 2019.
The study utilized the 2019 GBD dataset, which includes estimates for incidence, prevalence, and disability-adjusted life-years (DALYs) across 369 diseases. Age-standardized incidence rates (ASIRs) for LEAs were extracted for 21 MENA countries. Trends were analyzed using percentage change calculations and Joinpoint regression to identify significant shifts in LEA rates over time.
From 1990 to 2019, male LEA rates generally decreased, while female rates increased. Significant increases in LEA rates were observed in Syria, Yemen, and Afghanistan, correlating with periods of conflict and instability. Conversely, countries like Iraq, Palestine, Sudan, Lebanon, Iran, and Kuwait saw marked decreases. The study highlighted a complex interplay of socio-political factors, natural disasters, and chronic diseases like DM in shaping LEA trends across the region.
The study reveals variable LEA trends in the MENA region, influenced by conflicts, natural disasters, and chronic diseases. These findings underscore the need for targeted public health interventions, improved healthcare access, and robust data collection systems to reduce the burden of LEAs and improve patient outcomes in the MENA region.
下肢截肢（LEAs）显著增加了死亡率和发病率，其通常由外周动脉疾病和糖尿病（DM）导致。创伤性损伤也是许多 LEAs 的原因。尽管全球负担沉重，但 LEAs 的流行病学，特别是在中东和北非（MENA）地区，仍未得到充分探索。本研究利用全球疾病负担（GBD）数据集，分析了 1990 年至 2019 年 MENA 地区 LEAs 的时间趋势。
本研究利用 2019 年 GBD 数据集，该数据集包含了 369 种疾病的发病率、患病率和残疾调整生命年（DALYs）的估计值。从 21 个 MENA 国家中提取了 LEAs 的年龄标准化发病率（ASIRs）。使用百分比变化计算和 Joinpoint 回归分析来分析趋势，以确定 LEAs 率随时间的显著变化。
从 1990 年到 2019 年，男性 LEAs 率普遍下降，而女性率上升。在叙利亚、也门和阿富汗，LEAs 率显著上升，与冲突和不稳定时期相对应。相反，伊拉克、巴勒斯坦、苏丹、黎巴嫩、伊朗和科威特等国家则明显下降。该研究强调了社会政治因素、自然灾害和 DM 等慢性疾病在塑造该地区 LEAs 趋势方面的复杂相互作用。
本研究揭示了 MENA 地区 LEAs 趋势的多样性，受冲突、自然灾害和慢性疾病的影响。这些发现强调了需要有针对性的公共卫生干预措施、改善医疗保健获取途径和稳健的数据收集系统，以减少 MENA 地区 LEAs 的负担并改善患者的预后。
