Lower limb amputations in Trondheim, Norway

Figures & data

Table 1. Primary LLAs performed on citizens of Trondheim in 1994–1997 and 2004–2007

	1994-01-01 to 1997-01-01	2004-04-01 to 2007-04-01	p-value for difference
Inhabitants	143,000	159,000
Inhabitants with diabetes mellitus	2,870	3,610
All primary LLAs	143	113
Diabetic primary LLAs	47	38
Primary LLAs from peripheral vascular disease (PVD)	76	55
Other primary LLAs	20	20
Primary LLAs/10^5 inhabitants/year	33	24	0.007
Diabetic primary LLAs/10^5 inhabitants/year	11	8
Diabetic primary LLAs/10^3 diabetics/year	5.5	3.5	0.04
Major diabetic primary LLAs/10^3 diabetics/year	4.0	2.4	0.06
Primary LLAs from PVD/10^5/year	18	12	0.02

Table 2. All primary LLAs performed on citizens of Trondheim in 1994–97 and 2004–07 due to diabetes mellitus (DM), peripheral vascular disease (PVD), or for other reasons (such as trauma, infection, or malignant tumors)

	LLA due to DM		LLA due to PVD		LLA for other reasons
	1994–97	2004–07	1994–97	2004–07	1994–97	2004–07
Partial foot amputation	13	12	3	3	9	6
Ankle disarticulation	0	0	0	0	1	1
Transtibial amputation	16	8	12	17	3	5
Knee disarticulation	14	12	31	27	3	1
Transfemoral amputation	4	6	29	8	3	5
Hip disarticulation	0	0	1	0	1	2
Major LLA	34	26	73	52
All LLA	47	38	76	55
Ratio	0.7	0.7	1.0	1.0
95% CI	0.6–0.8	0.5–0.8	0.9–1.0	0.9–1.0

Table 3. Breakdown of major LLA in Trondheim in 1994–97 and 2004–07 in terms of patient age and sex

Age		< 60 years	60–69 years	≥ 70 years
1994–97	Male	5	16	41
	Female	3	4	49
2004–07	Male	8	7	37
	Female	1	2	37

Table 4. Re-amputations at the partial foot, transtibial, and knee disarticulation level in patients with diabetes mellitus (DM) and peripheral vascular disease (PVD)

Level	1994–1997Re-amputations / total (rate, CI)	2004–2007Re-amputations / total (rate, CI)
Partial foot amputation
Patients with DM	5/13 (0.4, CI: 0.2–0.6)	3/12 (0.3, CI: 0.1–0.5)
Patients with PVD	2/3 (0.7, CI: 0.2–0.9)	1/3 (0.3, CI: 0.1–0.8)
Transtibial amputation
Patients with DM	3/16 (0.2, CI: 0.1–0.4)	3/8 (0.4, CI: 0.1–0.7)
Patients with PVD	2/12 (0.2, CI: 0.0–0.4)	3/17 (0.2, CI: 0.1–0.4)
Knee disarticulation
Patients with DM	1/14 (0.1, CI: 0.0–0.3)	4/12 (0.3, CI: 0.1–0.6)
Patients with PVD	5/31 (0.2, CI: 0.1–0.3)	5/27 (0.2, CI: 0.1–0.4)

Table 5. Annual numbers of invasive and noninvasive vascular procedures performed in diabetic and non-diabetic subjects in Trondheim, 1998–2006

A	B	C	D	E	F	G
1998	3,074	142,704	8	18	9	40
1999	3,146	144,041	8	14	8	46
2000	3,219	145,640	9	11	10	48
2001	3,293	146,873	7	9	4	42
2002	3,370	148,038	9	15	10	47
2003	3,448	149,251	7	11	15	39
2004	3,528	150,823	8	10	12	30
2005	3,610	152,551	9	7	13	30
2006	3,694	154,919	9	6	12	20
Relative change in incidence per year ^a			–0.013	–0.107	0.046	–0.080
Estimate (upper 95% CL)			–0.096	–0.174	–0.034	–0.117
Estimate (lower 95% CL)			0.078	–0.036	0.133	–0.041
p-value			0.8	0.004	0.3	< 0.001

^a for example, –0.013 means a relative reduction of 1.3% per year. Computed as exp(beta) – 1, where beta is the coefficient for year in Poisson regression with the relevant population as exposure variable.

A Year

B Diabetic population, estimates based on 2,870 and 3,610 diabetics in 1995 and 2005, assuming a constant growth rate.

C Non-diabetic population, total population from Statistics Norway (www.ssb.no/english/) minus the estimated diabetic population in the preceding column

D Femoropopliteal and femorodistal bypasses in diabetic subjects

E Femoropopliteal and femorodistal bypasses non-diabetic subjects

F PTA in diabetic subjects

G PTA in non-diabetic subjects