Original articleEstimating the Prevalence of Limb Loss in the United States: 2005 to 2050
Section snippets
Overview
Our methodology is based on a multistate probabilistic model in which persons may move from a state without limb loss to the limb-loss state.27 Persons are at risk of death in each state. The model is illustrated schematically in figure 1. The input parameters to the model are the transition probabilities, which are the probabilities of moving from 1 state to the other. As described below, these transition probabilities are allowed to depend on age and calendar year. The model calculations are
2005 Estimates
An estimated 1.6 million persons were living with the loss of a limb in the year 2005. Table 1 illustrates how prevalence varies by etiology of the limb loss, age, sex, and race. Amputations secondary to dysvascular disease (n=846,000) account for most (54%) cases and of these, over two thirds have a comorbid diagnosis of diabetes (n=592,000). Limb loss secondary to trauma accounts for an additional 45% of the prevalent cases (n=704,000) and cancer for the remaining less than 2% (n=18,000).
Discussion
To our knowledge, this is the first study since 1996 to provide comprehensive estimates of the prevalence of limb loss in the U.S. population. The NHIS estimated 1.2 million cases of limb loss for 1996.26 Our result of 1.6 million in 2005 appears to be consistent with these results. The NHIS consisted of 40,000 households and includes cases of congenital limb loss and those treated on an outpatient basis, but it excludes persons who are institutionalized and those with amputations of only
Conclusions
This study estimated the prevalence of limb loss in the United States and projected these numbers into the future. As additional, more precise estimates of the incidence and mortality consequences of amputation become available, it will be possible to refine the magnitude of our estimates. Regardless of some uncertainty associated with the absolute size of our estimates, it is clear that the number of people living with the loss of a limb will continue to increase, driven in particular by the
Acknowledgment
The views expressed in this study are those of the authors. No official endorsement by the U.S. Centers for Disease Control and Prevention or the U.S. Department of Health and Human Services is intended or should be inferred.
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Supported by the U.S. Centers for Disease Control and Prevention (grant no. R04/CCU322981-02).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.