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Beitragstitel Epidemiology of Lower Extremity Amputations in Switzerland from 2005 to 2015
Beitragscode P54
  1. Jan Brtek Vortragender
  2. Thomas Böni Universitätsklinik Balgrist
  3. Felix Waibel Balgrist Universitätsklinik
Präsentationsform Poster
  • A07 - Spezialgebiet 2 | Infekte
Abstract Introduction: Lower extremity amputations (LEA) are usually performed for complications of diabetes, peripheral arterial disease (PAD), or a combination of both. The current epidemiologic literature on lower extremity amputations mainly derives from the 1990s and therefore mostly does not represent the progress in medical treatment. The aim of this study was to describe the etiologies of lower extremity amputations in Switzerland in the 21st century.
Methods: Swiss nationwide data collected by the Swiss Federal Statistical Office from all hospitalization records in Switzerland from January 1st 2005 to December 31st 2015 were analysed. Out of this dataset, all cases of lower extremity amputations were extracted. The amputation level was classified according to the Swiss operating classification while the indications for amputation were classified according to the ICD-10.
Results:21,315 lower extremity amputations occurred in the observation period. The total yearly number of amputations in Switzerland increased (+14.7%;p=0.048). Accordingly, the incidence increased from 24.9 to 25.6 per 100 000 people (+2.8%;p=0.460). While the minor amputation rate increased significantly from 17.9 to 20.8 per 100 000 people (+16.1%;p=0.041), the incidence of major amputations significantly decreased from 6.5 to 4.8 per 100 000 (-26.9%;p=0.0007). The majority of low extremity amputation was performed due to vascular diseases (35.9%), diabetes mellitus (23.7%) or infections (21.6%). Only 3.3% of the amputations were performed due to trauma. In patients aged 20-30 years the most frequent reason for LEA was trauma, accounting for 40.3% of the amputations in men and 27.5% in women. In patients aged between 30 and 40 years, trauma was also the main cause of amputation, men 46.9%; women 32.2%. The peak incidence of diabetes related amputations was the sixth decade (male 34.7%, female 26.2%) and the peak incidence of vascular related amputations was the tenth decade (male 55.5%, female 50.5%).
Conclusion: The major finding of this study is a significant decrease in major amputations which might best be explained by improved vascular and orthopedic treatment options in PAD, diabetic foot infections, and trauma. Interestingly, minor amputations increased significantly, what can be explained by the aging population and the increased incidence of Diabetes. Compared to the literature of prior decades, etiologies and their distribution in decades and between both sexes were similar.