Lower-Extremity Amputations Disproportionately Affect
Blacks and Mexican Americans
ABSTRACT Background. We sought to identify the age-adjusted incidence of lower-extremity amputation (LEA) in Mexican Americans, blacks, and non-Hispanic whites with diabetes in south Texas. Methods. We summarized medical records for hospitalizations for LEAs for 1993 in six metropolitan statistical areas in south Texas. Results. Age-adjusted incidence per 10,000 patients with diabetes was 146.59 in blacks, 60.68 in non-Hispanic whites, and 94.08 in Mexican Americans. Of the patients, 47% of amputees had a history of amputation, and 17.7% were hospitalized more than once during 1993. Mexican Americans had more diabetes-related amputations (85.9%) than blacks (74.7%) or non-Hispanic whites (56.3%). Conclusions. This study is the first to identify the incidence of diabetes-related lower-extremity amputations in minorities using primary data. Minorities had both a higher incidence and proportion of diabetes-related, LEAs compared with non-Hispanic whites. Public health initiatives and national strategies, such as Healthy People 2000 and 2010, need to specifically focus on high-risk populations and high-risk geographic areas to decrease the frequency of amputation and reamputation.
ARMSTRONG, DPM, LAWRENCE A. LAVERY, DPM, MPH, TERRI L.
QUEBEDEAUX, DPM, and STEVEN C. WALKER, MD, PhD, San