A population health analysis of trends in lower extremity amputation secondary to diabetes and peripheral artery disease, 2016–2023

Aims: This observational cohort study analyzes changes in amputation rates and inpatient outcomes for Illinois residents with diabetes and peripheral artery disease (PAD) admitted to non-federal hospitals. Methods: Hospital admissions for lower extremity amputations for Illinois residents from 2016 to 2023 were identified from the Illinois Hospital Association COMPdata database. Patients aged less than 34 years, with oncology or trauma-related diagnosis codes or isolated toe amputations were excluded. Average annual amputation rates per 100,000 by age group, sex, race/ethnicity and zip code household poverty levels were calculated using American Community Survey estimates. Results: There were 30,834 amputation admissions from 193 Illinois hospitals, increasing 65 % between 2016 and 2023. Rates of diabetes and hospital stays over 20 days increased significantly. Through foot amputations increased 129.4 %, with a decrease in Hi-Lo ratio to 1.04 from 1.83. The largest percent increases in amputation rates were for males (+76.1 %), non-Hispanic Black patients (+67.5 %), and residents aged 65 to 74 years old. Conclusion: Racial, socioeconomic and gender disparities in amputation rates appear to be increasing despite reduced smoking and therapeutic improvements, reflecting increasing diabetes and PAD prevalence. Health systems and community partners should emphasize aggressive prevention including screening, early diagnosis and intensive risk factor management.

Duke Scholars

Author Samantha Minc Surgery, Vascular and Endovascular Surgery