{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T21:48:49Z","timestamp":1794001729658,"version":"4.8.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2010,5,26]],"date-time":"2010-05-26T00:00:00Z","timestamp":1274832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000355","name":"BUPA Foundation","doi-asserted-by":"publisher","award":["Nov 07\/24"],"award-info":[{"award-number":["Nov 07\/24"]}],"id":[{"id":"10.13039\/501100000355","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,7,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The purpose of this study was to investigate the prevalence of lower extremity amputation in England, to establish the associated mortality, and to determine the relationship with diabetes mellitus and previous revascularization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data on all patients who had a lower extremity amputation between 2003 and 2008 were extracted from the Hospital Episode Statistics database. Risk adjustment and linear regression were used to compare the data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The major amputation rate was 5\u00b71 per 100 000 population and did not change over the 5 years. The mortality rate for major leg amputation was 16\u00b78 per cent (21\u00b74 per cent for above-knee and 11\u00b76 per cent for below-knee amputation); this decreased significantly over time (P &amp;lt; 0\u00b7001). There was a significant difference in amputation rate, mortality rate and the below-knee : above-knee amputation ratio between different areas of England (P &amp;lt; 0\u00b7001). Some 39\u00b74 per cent of patients who underwent major amputation had diabetes mellitus. The odds of revascularization before amputation increased significantly over time (P = 0\u00b7035).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Major and minor amputation rates were stable across England between 2003 and 2008, accompanied by a significant reduction in perioperative mortality. There were significant geographical variations in amputation rates, mortality rates and the below-knee : above-knee amputation ratio.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.7092","type":"journal-article","created":{"date-parts":[[2010,5,27]],"date-time":"2010-05-27T03:05:56Z","timestamp":1274929556000},"page":"1348-1353","source":"Crossref","is-referenced-by-count":166,"title":["Epidemiological study of lower limb amputation in England between 2003 and 2008"],"prefix":"10.1093","volume":"97","author":[{"given":"P W","family":"Moxey","sequence":"first","affiliation":[{"name":"Department of Outcomes Research, St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Hofman","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, Community Health Sciences, St George's University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J","family":"Hinchliffe","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M M","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P J E","family":"Holt","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2010,5,26]]},"reference":[{"key":"2021070910393287000_bib1","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1002\/(SICI)1096-9136(199703)14:3<214::AID-DIA339>3.0.CO;2-9","article-title":"Results and cost analysis of distal [crural\/pedal] arterial revascularisation for limb salvage in diabetic and non-diabetic patients","volume":"14","author":"Panayiotopoulos","year":"1997","journal-title":"Diabet Med"},{"key":"2021070910393287000_bib2","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/0741-5214(92)70025-G","article-title":"The economics of femorocrural reconstruction for critical leg ischemia with and without autologous vein","volume":"15","author":"Cheshire","year":"1992","journal-title":"J Vasc Surg"},{"key":"2021070910393287000_bib3","volume-title":"Payment by Results (PbR) in 2007\u201308.","author":"Department of Health"},{"key":"2021070910393287000_bib4","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1080\/09638280410001708869","article-title":"Psychosocial adjustment to lower-limb amputation: a review","volume":"26","author":"Horgan","year":"2004","journal-title":"Disabil Rehabil"},{"key":"2021070910393287000_bib5","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.amjsurg.2003.07.027","article-title":"Major lower extremity amputations at a Veterans Affairs hospital","volume":"186","author":"Cruz","year":"2003","journal-title":"Am J Surg"},{"key":"2021070910393287000_bib6","first-page":"875","article-title":"Limb amputation and limb deficiency: epidemiology and recent trends in the United States","volume":"95","author":"Dillingham","year":"2002","journal-title":"South Med J"},{"key":"2021070910393287000_bib7","doi-asserted-by":"crossref","first-page":"2027","DOI":"10.1016\/S0140-6736(09)60568-7","article-title":"Incidence trends for childhood type 1 diabetes in Europe during 1989\u20132003 and predicted new cases 2005\u201320: a multicentre prospective registration study","volume":"373","author":"Patterson","year":"2009","journal-title":"Lancet"},{"key":"2021070910393287000_bib8","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1046\/j.1365-2168.2000.01344.x","article-title":"Epidemiology of lower extremity amputation in centres in Europe, North America and East Asia. 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