Updated 02/2019 | Download PDF
Currently, 1.9 million people are living with limb loss in the United States, with an average of 507 people continuing to lose a limb every day. This results in an estimated 185,000 amputations per year (1), and this number is expected to double by the year 2050 due to increasing rates of diabetes and vascular disease (1). Among those living with limb loss, the major causes of their amputations are vascular disease (54%) – including diabetes and peripheral arterial disease – trauma (45%) and cancer (less than 2%) (2). The most common causes of pediatric amputations, however, are lawn mower accidents (3). Non-whites comprise about 42% of the limb loss population in the U.S. (1). In 2008, the diabetes related amputation rate among African Americans was nearly four times that of whites (4).
A total of 11,173 amputations were performed in Florida hospitals in 2014. These amputations were performed for a variety of reasons, including diabetes and peripheral arterial disease complications. The following information details the trends and most current rates of amputation and diabetes in Florida.
1. AMPUTATION TRENDS OVER TIME
According to hospital discharge data, there was an overall 32.24% increase of total amputations performed in Florida from 1997-2014. A total of 165,116 amputation procedures were performed in this time period. Amputations were at their lowest (8,449) in 1997. In 2014, amputations had increased to 11,173 (the highest number per year for this time period). (See Graph 1.1)
The number of upper- extremity amputations performed each year ultimately increased 85.55% from 1997 to 2014. A total of 10,899 upper-extremity amputation procedures were performed in this time period. The lowest incidence of these amputations (429) occurred in 2009, while 2014 saw the most upper-extremity amputations (796). (See Graph 1.2)
The number of lower extremity amputations performed each year ultimately increased 30.01% from 1997 to 2014. A total of 153,656 lower-extremity amputation procedures were performed in this time period. The incidence of these amputations dropped to 7,854 in 2007, but the numbers climbed again until they reached their highest point for this time period (10,377) in 2014. (See Graph 1.3)
2. TYPES OF AMPUTATIONS PERFORMED
768 upper-extremity amputations were performed in 2014. The most common minor upper-extremity amputations were of the fingers (613) and the most common major upper-extremity procedures were above the elbow 305). (See Graph 2.1)
10,361 lower-extremity amputations were performed in 2014. In terms of minor lower-extremity amputations, toes (5,276) were amputated more often than part of the foot (1408). For major lower- extremity amputations, below-knee (2,064) amputation was the most common procedure. (See Graph 2.2)
3. WHO LOSES A LIMB?
In 2014, most amputations were performed on individuals aged 45-64 years old, followed by the age group of 65-84 year olds (See Graph 3.1).
There were about 2.5 times more amputations performed on male patients in Florida than on female patients in 2014 (See Graph 3.2).
Medicare recipients ranked as the most common group to have an amputation procedure in Florida in 2014 (See Graph 3.3).
We can see that the African American residents of Florida bear the heaviest burden of amputation (0.089% of the African American population underwent amputations). This is evident when compared with the percentage of the white population that underwent amputations (0.044%) and with amputations in the state’s population as a whole (0.058%). (See Graph 3.4)
4. DIABETES TRENDS
In 2014, a total of 1,771,321 Floridians indicated that they had been diagnosed with diabetes at some point in their lives. The prevalence of diabetes in the population of Florida increased 252.8% from 1994 to 2014. (See Graph 4.1)
The annual rate of existing cases of diabetes among adults in Florida ultimately increased 104.3% from 1994 to 2014. (See Graph 4.2)
5. HEALTHCARE COSTS
For persons with a unilateral lower-extremity amputation, the two year healthcare costs, including initial hospitalization, inpatient rehabilitation, outpatient physical therapy, and purchase and maintenance of a prosthetic device, is estimated to be $91,106. The lifetime healthcare cost for persons with a unilateral lower extremity amputation is estimated to be more than $500,000 (5). It is anticipated that these healthcare costs would be higher for a person with a proximal amputation level and bilateral amputation status, due to higher prosthetic costs.
- Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the Prevalence of Limb Loss in the United States: 2005 to 2050. Archives of Physical Medicine and Rehabilitation2008;89(3):422-9.
- Coalition LLTFA. Recommendations from the 2012 Limb Loss Task Force: Roadmap for Preventing Limb Loss in America. [White Paper]. 2012 February 9-12.
- Bryant PR, Pandian G. Acquired limb deficiencies. 1. Acquired limb deficiencies in children and young adults. Archives of Physical Medicine and Rehabilitation2001;82(3B):00s3-s8.
- Li Y, Burrows NR, Gregg EW, Albright A, Geiss LS. Declining Rates of Hospitalization for Nontraumatic Lower-Extremity Amputation in the Diabetic Population Aged 40 Years or Older: U.S., 1988-2008. Diabetes Care2012;35(2):273-7.
- MacKenzie EJ. Health-Care Costs Associated with Amputation or Reconstruction of a Limb-Threatening Injury. The Journal of Bone and Joint Surgery (American)2007;89(8):1685.
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