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Table 1 Characteristics of inpatient cases with lower limb amputations 2005–2015 in Germany

From: Amputation rates of the lower limb by amputation level – observational study using German national hospital discharge data from 2005 to 2015

  2005 2007 2009 2011 2013 2015
Number of cases with lower limb amputation N 52,096 51,922 53,646 53,956 55,115 55,595
Number of hospitals N 1,344 1,281 1,249 1,194 1,142 1,109
Median annual case number per hospital (IQR) 25 (11–56) 25 (11–58) 27 (11–63) 28 (11–68) 30 (11–73) 33 (10–75)
Average length of stay 30.6 29.6 27.5 25.9 25.1 24.0
In-hospital mortality N (%) 5,837 (11.2%) 5,462 (10.5%) 5,011 (9.3%) 4,518 (8.4%) 4,482 (8.1%) 4,276 (7.7%)
Women N (%) 19,718 (37.8%) 18,974 (36.5%) 18,571 (34.6%) 17,779 (33.0%) 17,723 (32.2%) 16,971 (30.5%)
Median age (IQR) 72 (64–80) 72 (65–80) 73 (65–80) 73 (65–81) 74 (64–81) 74 (64–81)
Underlying disease N (%)
 Diabetes mellitus without peripheral arterial diseasea 6,166 (11.8%) 5,557 (10.7%) 5,161 (9.6%) 5,454 (10.1%) 5,386 (9.8%) 6,075 (10.9%)
 Diabetes mellitus with peripheral arterial diseasea 23,887 (45.9%) 24,595 (47.4%) 26,168 (48.8%) 26,286 (48.7%) 26,398 (47.9%) 26,492 (47.6%)
 Peripheral arterial disease without diabetes mellitusa 12,198 (23.4%) 12,431 (23.9%) 12,519 (23.3%) 12,213 (22.7%) 12,560 (22.8%) 12,272 (22.1%)
 Other diseases 9,845 (18.9%) 9,339 (18.0%) 9,798 (18.3%) 10,003 (18.5%) 10,771 (19.5%) 10,756 (19.4%)
 Diabetic foot syndromeb 19,674 (36.7%) 22,240 (41.2%) 22,874 (41.5%) 24,371 (43.8%)
Amputation level N (%)
 Hip joint/femoral 13,958 (26.8%) 13,074 (25.2%) 12,342 (23.0%) 11,238 (20.8%) 10,575 (19.2%) 9644 (17.3%)
 Knee/lower leg 8,713 (16.7%) 8,149 (15.7%) 7,714 (14.4%) 6,813 (12.6%) 6,515 (11.8%) 6,411 (11.5%)
 Foot complete 381 (0.7%) 306 (0.6%) 274 (0.5%) 314 (0.6%) 331 (0.6%) 310 (0.6%)
 Mid−/forefoot 6,825 (13.1%) 7,613 (14.7%) 8,505 (15.9%) 9,281 (17.2%) 9,764 (17.7%) 8,378 (15.1%)
 Toe/foot ray 21,419 (41.1%) 21,795 (42.0%) 23,941 (44.6%) 25,510 (47.3%) 27,167 (49.3%) 29,153 (52.4%)
 Hemipelvectomy 60 (0.1%) 63 (0.1%) 43 (0.1%) 68 (0.1%) 60 (0.1%) 45 (0.1%)
 Leg miscellaneous/not further stated 66 (0.1%) 65 (0.1%) 47 (0.1%) 34 (0.1%) 50 (0.1%) 31 (0.1%)
 Foot miscellaneous/not further stated or interiorc 674 (1.3%) 857 (1.7%) 780 (1.5%) 698 (1.3%) 653 (1.2%) 1623 (2.9%)
Revascularization during the same hospital stay N (%)
 Surgery of peripheral arteries 9,094 (17.5%) 9,352 (18.0%) 9,470 (17.7%) 9,125 (16.9%) 9,201 (16.7%) 8,727 (15.7%)
 Percutaneous transluminal angioplasty 5,463 (10.5%) 6,730 (13.0%) 8,616 (16.1%) 10,166 (18.8%) 11,622 (21.1%) 12,343 (22.2%)
Reamputation during the same hospital stay N (%)
 Cases with reamputation 6,861 (13.2%) 6,516 (12.5%) 6,090 (11.4%) 5,889 (10.9%) 5,715 (10.4%) 5,646 (10.2%)
 In-hospital mortality among cases with reamputation N (%) 997 (14.5%) 921 (14.1%) 819 (13.4%) 717 (12.2%) 718 (12.6%) 663 (11.7%)
  1. IQR: Interquartile Range (25.-75. percentile). For better representation, only every second year is displayed
  2. aPrincipal or secondary diagnosis
  3. bPrincipal or secondary diagnosis. A specific diagnosis code for diabetic foot syndrome was introduced to the ICD-10-GM in 2009
  4. cA specific procedure code for interior amputations in the area of the midfoot and footroot bone was introduced to the OPS in 2014 (until 2014 such amputations were presumably coded as foot miscellaneous/not further stated)