FORTY PERCENT DECREASE IN THE INCIDENCE OF DIABETIC AMPUTATIONS IN TEN YEARS

Abstract

Introduction: We have previously reported on an incidence of diabetic amputations of 4, 4 per 1.000 diabetic subjects per year in the city of Trondheim, Norway, 1994–1997. As a consequence of that study, Trondheim Diabetic Foot Team was established January 1st 1996. The Diabetic Foot Team has been an integrated part of the Outpatient clinic, Department of Orthopaedic Surgery, St. Olavs University Hospital. We report on the incidence of diabetic amputations ten years later (2004–2007).

Material and Methods: The University Hospital is the only hospital in Trondheim, and all amputations are performed at the Department of Orthopaedic Surgery. In 2004–2007 we registered consecutively all diabetic amputations. During the two study periods, 1994–1997 and 2004–2007, the population of Trondheim was 143.300 and 159.000 inhabitants, respectively. The total number of diabetic subjects in Trondheim during the two study periods was 3.600 and 4.600, respectively.

Changes in incidence rates were analyzed using Poisson regression with decade as covariate. Two sided p-values < 0.05 were considered significant. Analyses were performed in State version10.0.

Results: During the decade the number of diabetic amputations/1000 diabetics/year decreased 40 percent from 4, 4 to 2, 8 (p= 0.04). In the same period, 779 patients with diabetes were screened at the Diabetic Foot Team, and 5915 consultations due to diabetic foot problems were performed. From 1996 to 2006 the number of invasive and non-invasive vascular intervention per year in patients with diabetes living in Trondheim did not change.

Discussion: Although other factors may be involved, we attribute the decrease in the incidence of diabetic amputations to the activity of the Diabetic Foot Team. Every department of orthopaedic surgery should make priority to the implementation of a multidisciplinary program for prevention and treatment of diabetic foot ulcers.