van Houtum W H, Lavery L A, Harkless L B
Mexican American Medical Treatment Effectiveness Research Center, University of Texas Health Science Center at San Antonio 78284-7776, USA.
J Diabetes Complications. 1996 Nov-Dec;10(6):325-30. doi: 10.1016/1056-8727(95)00088-7.
The purpose of this study is to identify the incidence of diabetes-related lower-extremity amputations in the Netherlands. We used discharge records from SIG Health Care Information for every hospitalization for a lower-extremity amputation in all hospitals in the Netherlands in 1992. Age- and gender-specific population figures and diagnosed cases of diabetes were obtained from the Central Bureau of Statistics. Age- and gender-adjusted amputation incidences were identified at four different levels (toe, foot, leg, and thigh). Multiple amputations were analyzed by the highest level. Of all lower-extremity amputations, 1,575 (47%) were in persons with diabetes mellitus. Age- and gender-adjusted lower-extremity amputation rates per 10,000 persons with diabetes by level were the following: toe 12.39, foot 2.42, leg 7.82, thigh 2.54, and total 25.17. People with diabetes were 20.3 times more likely to experience a lower-extremity amputation than people without diabetes. Males were at a significantly higher risk of experiencing an amputation than females. There was a significant increase in the age-specific incidence of amputations as age increased. The most common amputation procedure performed was the toe amputation. There was a significant increase in thigh amputations as age increased, indicating that as people get older they suffer higher levels of amputations. Although the incidence of lower-extremity amputations was lower than previous reports, they still have a serious impact on the health-care system in the Netherlands.
本研究的目的是确定荷兰糖尿病相关下肢截肢的发生率。我们使用了SIG医疗保健信息公司提供的1992年荷兰所有医院下肢截肢患者每次住院的出院记录。年龄和性别特异性人口数据以及糖尿病确诊病例来自中央统计局。在四个不同水平（趾、足、小腿和大腿）确定了年龄和性别调整后的截肢发生率。多处截肢按最高水平进行分析。在所有下肢截肢病例中，1575例（47%）为糖尿病患者。按水平计算，每10000名糖尿病患者的年龄和性别调整后的下肢截肢率如下：趾部12.39、足部2.42、小腿7.82、大腿2.54，总计25.17。糖尿病患者发生下肢截肢的可能性是无糖尿病患者的20.3倍。男性发生截肢的风险显著高于女性。随着年龄增长，特定年龄的截肢发生率显著增加。最常见的截肢手术是趾部截肢。随着年龄增长，大腿截肢显著增加，这表明随着人们年龄的增长，截肢水平更高。尽管下肢截肢的发生率低于先前的报告，但它们仍然对荷兰的医疗保健系统产生严重影响。
