The influence of socio-economic deprivation on rates of major lower limb amputation secondary to peripheral arterial disease.

Abstract

OBJECTIVES:

To investigate a hypothesised link between socio-economic deprivation and rates of major lower limb amputation within the catchment of a district general hospital in the United Kingdom.

DESIGN:

An analysis of a demographic database collated using patients identified by the OPCS codes for lower limb amputations.

MATERIALS:

All patients undergoing a lower limb amputation as a result of peripheral vascular disease, as identified by ICD-10 code, between January 2003 and January 2009 were included in the study.

METHODS:

A case-control study was undertaken, comparing the Index of Multiple Deprivation 2007 (IMD) scores of major lower limb amputees, to those of the catchment population. Multivariate analysis was not undertaken.

RESULTS:

A total of 327 patients underwent 445 lower limb amputations during the 6-year period. A comparative plot of cumulative frequency of IMD score in the catchment and amputation groups indicates greater numbers of major amputations in more deprived postcodes (P=0.004). The catchment population was further divided into population-matched deprivation quintiles. A significant increase in the number of amputations occurred in the two most deprived quintiles (OR (95%CI)=1.654 (1.121-2.440), P=0.011)

CONCLUSIONS:

This study indicates a positive association between increasing social deprivation and rates of lower limb amputation. If the most deprived quintiles are combined, this increase in amputation rates is approximately 65%. This inequity should be further investigated, and consideration given to targeted care within areas of greater social deprivation.

• Authors: H J M Ferguson, P Nightingale, R Pathak, A P Jayatunga
• Journal: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (Eur J Vasc Endovasc Surg) Vol. 40 Issue 1 Pg. 76-80 (Jul 2010) ISSN: 1532-2165 [Electronic] England
• PMID: 20362475 (Publication Type: Journal Article)
• Copyright: Copyright 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Topics

• Amputation, Surgical (statistics & numerical data)
• Amputees (statistics & numerical data)
• Case-Control Studies
• Chi-Square Distribution
• England (epidemiology)
• Hospitals, District (statistics & numerical data)
• Hospitals, General (statistics & numerical data)
• Humans
• Logistic Models
• Lower Extremity (blood supply)
• Odds Ratio
• Patient Acceptance of Health Care
• Peripheral Vascular Diseases (epidemiology, psychology, surgery)
• Postal Service
• Poverty Areas
• Residence Characteristics (statistics & numerical data)
• Risk Assessment
• Risk Factors
• Social Class
• Socioeconomic Factors