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Incidence of lower limb amputation in Canada

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Abstract

OBJECTIVES: To determine the Canadian age-adjusted incidence rates of lower limb amputation (LLA) by province, sex, level, and cause of amputation.

METHODS: Data on all hospital discharges associated with LLA from April 1,2006, to March 31,2012, were obtained from the Canadian Institute for Health Information’s Discharge Abstract Database. National and provincial age-adjusted rates were calculated per 100 000 individuals by sex, level, and cause of LLA using the direct method of standardization. The relative risk of LLA in people with diabetes was calculated.

RESULTS: There were a total of 44 430 LLAs performed in Canada over the study years. The number of LLAs increased from 7331 in 2006 to 7708 in 2011. Mean (SD) age was 65.7 (16.6) years, and 68.8% were males. Sixty-five percent of the LLA cases were due to diabetes. The average age-adjusted rate of LLA in Canada was 22.9 per 100000 individuals. The age-adjusted rates declined over the study years. The relative risk of diabetes-related LLAs was 28.9.

CONCLUSION: This study provided the first Canadian national and provincial age-adjusted incidence rates of LLA and a baseline for monitoring and evaluation in the future. Understanding the incidence of LLA is essential to managing preventive and rehabilitation services for this population. Although the age-adjusted LLA incidence rates have decreased, the number of new LLAs has increased. The increase in the number of LLAs has important implications for social and health care costs.

Résumé

OBJECTIFS : Déterminer les taux d’incidence des amputations de membres inférieurs (AMI) rajustés selon l’âge au Canada par province, par sexe, par niveau et par cause d’amputation.

MÉTHODE : Les données sur les sorties de l’hôpital associées aux AMI entre le 1er avril 2006 et le 31 mars 2012 proviennent de la Base de données sur les congés des patients de l’Institut canadien d’information sur la santé. Les taux nationaux et provinciaux rajustés selon l’âge ont été calculés pour 100 000 habitants par sexe, par niveau et par cause d’AMI selon la méthode de standardisation directe. Le risque relatif d’AMI chez les personnes diabétiques a aussi été calculé.

RÉSULTATS : En tout, 44 430 AMI ont été effectuées au Canada au cours de la période à l’étude. Le nombre d’AMI a augmenté, passant de 7 331 en 2006 à 7 708 en 2011. L’âge moyen (SD) des patients était de 65,7 ans (16,6), et 68,8 % étaient des hommes. Soixante-cinq p. cent des cas d’AMI étaient dus au diabète. Le taux moyen d’AMI rajusté selon l’âge au Canada était de 22,9 pour 100 000 habitants. Les taux rajustés selon l’âge ont baissé au cours des années de l’étude. Le risque relatif d’AMI liée au diabète était de 28,9.

CONCLUSION : Cette étude est la première à fournir les taux d’incidence des AMI nationaux et provinciaux rajustés selon l’âge au Canada et constitue une base de référence pour en faire le suivi et l’évaluation à l’avenir. Il est essentiel de comprendre l’incidence des AMI pour gérer les services de prévention et de réadaptation dans la population en question. Bien que les taux d’incidence des AMI rajustés selon l’âge aient diminué, le nombre de nouvelles AMI augmente. Cette augmentation a d’importantes répercussions sur les coûts des soins de santé et des services sociaux.

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Author information

Authors and Affiliations

  1. Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada

    Bita Imam PhD, William C. Miller PhD, FCAOT, Janice J. Eng PhD, PT & Tal Jarus PhD, OT

  2. Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada

    William C. Miller PhD, FCAOT & Tal Jarus PhD, OT

  3. Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada

    Heather C. Finlayson MD, FRCPC

  4. Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada

    Janice J. Eng PhD, PT

Authors
  1. Bita Imam PhD
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  2. William C. Miller PhD, FCAOT
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  3. Heather C. Finlayson MD, FRCPC
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  4. Janice J. Eng PhD, PT
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Corresponding author

Correspondence to William C. Miller PhD, FCAOT.

Additional information

Acknowledgements: We acknowledge the Canadian Institute for Health Information for providing the data for this study and our staff at GF Strong Rehabilitation Research Program for helping with the study.

Funding: This study was funded by Amputee Coalition of Canada and the University of Alberta’s Faculty of Medicine & Dentistry-Franklin Fund. Vanier Canada graduate scholarships provided salary for Bita Imam. Michael Smith Foundation provided salary for Janice Eng.

Conflict of Interest: None to declare.

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Imam, B., Miller, W.C., Finlayson, H.C. et al. Incidence of lower limb amputation in Canada. Can J Public Health 108, 374–380 (2017). https://doi.org/10.17269/CJPH.108.6093

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