The Influence of Socio-economic Deprivation on Rates of Major Lower Limb Amputation Secondary to Peripheral Arterial Disease

https://doi.org/10.1016/j.ejvs.2010.03.008Get rights and content
Under an Elsevier user license
open archive

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.

Keywords

Amputation
Social class
Socio-economic factors
Peripheral Arterial diseases
Peripheral vascular diseases

Cited by (0)