Incidence and prognosis of dysvascular amputations in Okayama Prefecture (Japan)

This survey analysed the clinical characteristics of subjects who first underwent major amputation of lower limbs necessitated by dysvascular disease during the 5 year period from 1984 to 1988. All were residents of Okayama Prefecture, Japan, and have been issued with a Physically Disabled Person's Certificate. In total, 114 dysvascular amputees, representing 58.2% of all lower limb amputations performed in the resident population during the study period, were surveyed. The underlying diagnosis was arteriosclerotic obstruction in 64.9% of the subjects, diabetic gangrene in 22.8%, acute embolism in 7.0% and Buerger's disease in 5.3%. The yearly incidence of new dysvascular amputees per 100,000 people was estimated to be 1.2 among the general population and 5.7 among those aged over 65 years. At three years after primary amputation, the survival rate was 52.3% in arteriosclerotic obstruction, and 66.7% in diabetic gangrene. Secondary amputation was performed in 17.0% of the entire group. The concurrent incidence of hemiplegic stroke was 19.8%. Among 36 amputees due to arteriosclerotic obstruction, who survived 3 years postoperatively, 10 (27.8%) were fitted with prosthetic limbs.