Variation in the incidence and proportion of diabetes-related amputations in minorities

Lawrence A. Lavery, Hisham R. Ashry, William Van Houtum, Jacqualine A. Pugh, Lawrence B. Harkless, Srabashi Basu

Research output: Contribution to journalArticle

189 Citations (Scopus)

Abstract

OBJECTIVE - To identify the age-adjusted and level-specific incidence of amputations associated with diabetes in Hispanics, African-Americans, and non-Hispanic whites. RESEARCH DESIGN AND METHODS - We used a database from the Office of Statewide Planning and Development in California that identified all hospitalizations for lower-extremity amputations in the state in 1991. Amputation level was defined by ICD-9-CM codes 84, 11-84 and were categorized as toe, foot, leg, and thigh amputations. RESULTS - The age- adjusted incidence of diabetes-related amputation per 10,000 persons with diabetes in 1991 was 95.25 in African-Americans, 55.98 in non-Hispanic whites, and 44.43 in Hispanics. Hispanics had a higher proportion of amputations (82.7%) associated with diabetes than did African-Americans (61.6%) or non-Hispanic whites (56.8%) (P < 0.001). African-Americans had the highest age-adjusted incidence rate for each level in people with and without diabetes. African-Americans underwent more proximal amputations compared with non-Hispanic whites and Hispanics (P < 0.001). Diabetes-related amputations were 1.72 and 2.17 times more likely in African-Americans compared with non- Hispanic whites and Hispanics, respectively. CONCLUSIONS - Hispanics had proportionally more amputations associated with diabetes than did African- Americans or non-Hispanic whites. A significant excess incidence of both diabetes- and non-diabetes-related amputations and proportionally more proximal amputations were identified in African-Americans compared with Hispanics and non-Hispanic whites. A possible explanation could be the higher prevalence of peripheral vascular disease in African-Americans. Public health initiatives, which have been demonstrated to reduce the incidence of diabetes-related lower-extremity amputations, should be implemented, and additional work should focus on minority groups.

Original languageEnglish (US)
Pages (from-to)48-52
Number of pages5
JournalDiabetes Care
Volume19
Issue number1
StatePublished - Jan 1996

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Amputation
African Americans
Hispanic Americans
Incidence
Lower Extremity
Minority Groups
Peripheral Vascular Diseases
Toes
International Classification of Diseases
Thigh
Foot
Leg
Hospitalization
Research Design
Public Health
Databases

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Lavery, L. A., Ashry, H. R., Van Houtum, W., Pugh, J. A., Harkless, L. B., & Basu, S. (1996). Variation in the incidence and proportion of diabetes-related amputations in minorities. Diabetes Care, 19(1), 48-52.

Variation in the incidence and proportion of diabetes-related amputations in minorities. / Lavery, Lawrence A.; Ashry, Hisham R.; Van Houtum, William; Pugh, Jacqualine A.; Harkless, Lawrence B.; Basu, Srabashi.

In: Diabetes Care, Vol. 19, No. 1, 01.1996, p. 48-52.

Research output: Contribution to journalArticle

Lavery, LA, Ashry, HR, Van Houtum, W, Pugh, JA, Harkless, LB & Basu, S 1996, 'Variation in the incidence and proportion of diabetes-related amputations in minorities', Diabetes Care, vol. 19, no. 1, pp. 48-52.
Lavery LA, Ashry HR, Van Houtum W, Pugh JA, Harkless LB, Basu S. Variation in the incidence and proportion of diabetes-related amputations in minorities. Diabetes Care. 1996 Jan;19(1):48-52.
Lavery, Lawrence A. ; Ashry, Hisham R. ; Van Houtum, William ; Pugh, Jacqualine A. ; Harkless, Lawrence B. ; Basu, Srabashi. / Variation in the incidence and proportion of diabetes-related amputations in minorities. In: Diabetes Care. 1996 ; Vol. 19, No. 1. pp. 48-52.
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abstract = "OBJECTIVE - To identify the age-adjusted and level-specific incidence of amputations associated with diabetes in Hispanics, African-Americans, and non-Hispanic whites. RESEARCH DESIGN AND METHODS - We used a database from the Office of Statewide Planning and Development in California that identified all hospitalizations for lower-extremity amputations in the state in 1991. Amputation level was defined by ICD-9-CM codes 84, 11-84 and were categorized as toe, foot, leg, and thigh amputations. RESULTS - The age- adjusted incidence of diabetes-related amputation per 10,000 persons with diabetes in 1991 was 95.25 in African-Americans, 55.98 in non-Hispanic whites, and 44.43 in Hispanics. Hispanics had a higher proportion of amputations (82.7{\%}) associated with diabetes than did African-Americans (61.6{\%}) or non-Hispanic whites (56.8{\%}) (P < 0.001). African-Americans had the highest age-adjusted incidence rate for each level in people with and without diabetes. African-Americans underwent more proximal amputations compared with non-Hispanic whites and Hispanics (P < 0.001). Diabetes-related amputations were 1.72 and 2.17 times more likely in African-Americans compared with non- Hispanic whites and Hispanics, respectively. CONCLUSIONS - Hispanics had proportionally more amputations associated with diabetes than did African- Americans or non-Hispanic whites. A significant excess incidence of both diabetes- and non-diabetes-related amputations and proportionally more proximal amputations were identified in African-Americans compared with Hispanics and non-Hispanic whites. A possible explanation could be the higher prevalence of peripheral vascular disease in African-Americans. Public health initiatives, which have been demonstrated to reduce the incidence of diabetes-related lower-extremity amputations, should be implemented, and additional work should focus on minority groups.",
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