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Logo for the Journal of Rehab R&D
Vol. 37 No. 1, 2000
Pages 23 - 30

Abstract - Trends in lower limb amputation in the Veterans Health Administration, 1989-1998

Jennifer A. Mayfield, MD, MPH; Gayle E. Reiber, PhD, MPH; Charles Maynard, PhD; Joseph M. Czerniecki, MD; Michael T. Caps, MD, MPH; Bruce J. Sangeorzan, MD

Center of Excellence in Amputation, Prosthetics, and Limb Loss Prevention, Rehabilitation Research and Development, Puget Sound Health Care System, Seattle, WA 98108; VA Epidemiologic Research and Information Center (ERIC), Seattle, WA 98108

Abstract--Objective: To assess trends in lower limb amputation performed in Veterans Health Administration (VHA) facilities.
Methods: All lower limb amputations recorded in the Patient Treatment File for 1989-1998 were analyzed using the hospital discharge as the unit of analysis. Age-specific rates were calculated using the VHA user-population as the denominator. Frequency tables and linear, logistic, and Poisson regression were used respectively to assess trends in amputation numbers, reoperation rates, and age-specific amputation rates.
Results: Between 1989-1998, there were 60,324 discharges with amputation in VHA facilities. Over 99.9% of these were in men and constitute 10 percent of all US male amputations. The major indications were diabetes (62.9%) and peripheral vascular disease alone (23.6%). The age-specific rates of major amputation in the VHA are higher than US rates of major amputation. VHA rates of major and minor amputation declined an average of 5% each year, while the number of diabetes-associated amputations remained the same.
Conclusion: The number and age-specific rates of amputations decreased over 10 years despite an increase in the number of veterans using VHA care.

Key words: amputation epidemiology.

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