Observational studyBMC health services research2019
Amputation rates of the lower limb by amputation level - observational study using German national hospital discharge data from 2005 to 2015.
Observational study in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06448260 (Outcome of a Cohort of Patients Fitted With a SYME Type Prosthesis in the Context of a Hindfoot Amputation With Distal Support), which is not on this map. Cited by 39 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Outcome of a Cohort of Patients Fitted With a SYME Type Prosthesis in the Context of a Hindfoot Amputation With Distal Support
Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Determinant Causes of Limb Amputation in Ethiopia: A Systematic Review and Meta-Analysis.Ethiopian journal of health sciences · 2023Pooled it
- Primary prophylaxis for venous thromboembolism in people undergoing major amputation of the lower extremity.The Cochrane database of systematic reviews · 2020Pooled it
- Recovery After Nontraumatic Lower Limb Amputation: A Scoping Review of Longitudinal Research Studies.Archives of rehabilitation research and clinical translation · 2026Review
- A comparative study of limb load on the healthy side of above-knee amputees after reconstruction of assistive walking devices.Medicine · 2025Article
- Gait Characteristics of People with Hallux and Forefoot Amputations-A Case Series.Journal of clinical medicine · 2025Article
- [Major amputations of the lower extremity].Unfallchirurgie (Heidelberg, Germany) · 2025Review
- The misleading terminology of minor amputation of the lower limb.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Risk factors and rates of revision amputation following ischemic lower major limb amputations: A 10-year retrospective analysis.Joint diseases and related surgery · 2025Article
- Health implications of lower extremity amputations in Jordan: A retrospective analysis of demographic patterns and causes.PloS one · 2025Article
- Risk factors and predictors of prolonged hospital stay in the clinical course of major amputations of the upper and lower extremity a retrospective analysis of a level 1-trauma center.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Use of blood parameters for the prediction of mortality in patients with below‑knee amputation.Experimental and therapeutic medicine · 2024Article
- FHIR-standardized data collection on the clinical rehabilitation pathway of trans-femoral amputation patients.Scientific data · 2024Article
- Towards efficient motor imagery interventions after lower-limb amputation.Journal of neuroengineering and rehabilitation · 2024Article
- Postural control imbalance in individuals with a minor lower extremity amputation: a scoping review protocol.F1000Research · 2024Article
- Comorbidity and risk factors of subsequent lower extremity amputation in patients diagnosed with diabetes in Saskatchewan, Canada.Chronic illness · 2023Article
- Localization of composite prosthetic feet: manufacturing processes and production guidelines.Scientific reports · 2023Article
- Salami-Tactics: when is it time for a major cut after multiple minor amputations?Archives of orthopaedic and trauma surgery · 2023Article
- Demographics and Etiology for Lower Extremity Amputations-Experiences of an University Orthopaedic Center in Germany.Medicina (Kaunas, Lithuania) · 2023Article
- A real-time and convex model for the estimation of muscle force from surface electromyographic signals in the upper and lower limbs.Frontiers in physiology · 2023Article
- Mobility and postural limitations perceived by transtibial amputees undertaking agricultural activities: a qualitative study.Annals of medicine · 2023Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn international comparisons, rates of amputations of the lower limb are relatively high in Germany. This study aims to analyze trends in lower limb amputations over time, as well as outcomes of care concerning in-hospital mortality and reamputation rates during the same hospital stay which might indicate the quality of surgical and perioperative health care processes.
methodsThis work is an observational population-based study using complete national hospital discharge data (Diagnosis-Related Group Statistics (DRG Statistics)) from 2005 to 2015. All inpatient cases with lower limb amputation were identified and stratified by eight amputation levels. Time trends of case numbers and in-hospital mortality were studied age-sex standardized. For inpatient cases with reamputation during the same hospital stay, first and last amputation levels were cross tabulated.
resultsA total of 55,595 amputations of the lower limb in 2015 (52,096 in 2005) were identified. After age-sex standardization to the demographic structure of 2005, a relative decrease of - 11.1% was revealed (men - 2.6%, women - 25.0%). The stratified analysis by amputation levels showed that the decreases were induced by higher amputation levels, whereas the amputation levels of toe/foot ray after standardization still showed a relative increase of + 12.8%. In-hospital mortality of all cases with lower limb amputation fell from 11.2% in 2005 to 7.7% in 2015 (SMR 0.89 [95% CI 0.86; 0.92]). The percentage of reamputations during the same hospital stay declined from 13.2 to 10.2%.
conclusionsThe number of lower limb amputations declined in Germany, however distinctly stronger in women than in men. The observed decreases of in-hospital mortality as well as of reamputation rates point to improvements in perioperative health care. Despite these indications of improvements, the distinct increase in case numbers at the level of toe/foot ray calls for additional targeted prevention efforts, especially for patients with diabetes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.