, Volume 55, Issue 12, p 3396
Date: 01 Oct 2012

Potential inaccuracy in recording the presence of diabetes in people with amputations of the lower limb in hospitals in England

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To the Editor: We applaud Holman et al [1] for gathering data regarding the incidence of major lower limb amputations in people with diabetes. However, we believe that comparison of areas covered by primary care trusts (PCTs) is not sufficiently accurate because of poor quality data collection in hospitals in England. Data regarding prevalence of diabetes were gleaned from general practice systems, generated during clinical care. Data recording co-existence of diabetes are taken from hospital episode statistics (HES), usually collected by non-clinical coders, after perusal of hospital notes.

We have examined the case records of all patients coded as having major lower limb amputations in two hospitals that are the major catchment of our two PCTs, for the same time period. There were 21 patients in Shropshire County PCT (SCPCT), and 15 in Telford and Wrekin PCT (TWPCT), a prevalence of 0.58 and 0.71 amputations per year per 1,000 people with diabetes respectively (as opposed to 0.6–0.9 a ...