Seasonal variations in lower extremity amputation

David G. Armstrong, Lawrence A. Lavery, William H. Van Houtum, Lawrence B. Harkless

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

The purpose of this study was to examine seasonal variations in nontraumatic amputation among diabetic and nondiabetic adults. We abstracted data from a database supplied by the state of New York for 14,555 amputations performed in 1990 and 1991. We categorized amputations into three different levels (foot, leg, and thigh). The most common season for a patient with diabetes to receive a lower-extremity amputation was spring (27.0%, p<0.004; odds ratio 1.1, confidence interval 1.0 to 1.2), while winter was the most common in nondiabetic patients (27.3%, p<0.005; odds ratio 1.1, confidence interval 1.0 to 1.2). When stratified by amputation level, fewer amputations at the level of the foot occurred during winter in patients with diabetes compared with these without diabetes (24.5% vs. 28.2%, p<0.002; X2(MH) = 193.1, odds ratio = 1.2, confidence interval = 1.1 to 1.4). Fall was the least common season for amputation at nearly every level for both diabetic and nondiabetic groups, and more diabetic patients presented with an admission diagnosis of vascular disease (74.6% vs. 54.9%, p<0.0001; X2(MH)= 612.3, odds ratio = 2.4, confidence interval = 2.3 to 2.6). In most diabetic patients, a primary etiologic factor for amputation is an infected neuropathic ulceration brought about or exacerbated by increased activity. By limiting activity, cold weather should act as a protective measure. The data in this study seem to support this notion.

Original languageEnglish (US)
Pages (from-to)146-150
Number of pages5
JournalJournal of Foot and Ankle Surgery
Volume36
Issue number2
StatePublished - Mar 1997

Fingerprint

Amputation
Lower Extremity
Odds Ratio
Confidence Intervals
Foot
Weather
Thigh
Vascular Diseases
Leg
Databases

Keywords

  • amputation
  • diabetes mellitus
  • foot
  • ischemia
  • neuropathy

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Armstrong, D. G., Lavery, L. A., Van Houtum, W. H., & Harkless, L. B. (1997). Seasonal variations in lower extremity amputation. Journal of Foot and Ankle Surgery, 36(2), 146-150.

Seasonal variations in lower extremity amputation. / Armstrong, David G.; Lavery, Lawrence A.; Van Houtum, William H.; Harkless, Lawrence B.

In: Journal of Foot and Ankle Surgery, Vol. 36, No. 2, 03.1997, p. 146-150.

Research output: Contribution to journalArticle

Armstrong, DG, Lavery, LA, Van Houtum, WH & Harkless, LB 1997, 'Seasonal variations in lower extremity amputation', Journal of Foot and Ankle Surgery, vol. 36, no. 2, pp. 146-150.
Armstrong DG, Lavery LA, Van Houtum WH, Harkless LB. Seasonal variations in lower extremity amputation. Journal of Foot and Ankle Surgery. 1997 Mar;36(2):146-150.
Armstrong, David G. ; Lavery, Lawrence A. ; Van Houtum, William H. ; Harkless, Lawrence B. / Seasonal variations in lower extremity amputation. In: Journal of Foot and Ankle Surgery. 1997 ; Vol. 36, No. 2. pp. 146-150.
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