INCIDENCE AND PROGNOSIS OF DYSVASCULAR AMPUTATIONS IN OKAYAMA PREFECTURE (JAPAN)

This survey analysed the clinical characteristics of subjects who firs t underwent major amputation of lower limbs necessitated by dysvascula r disease during the 5 year period from 1984 to 1988. All were residen ts of Okayama Prefecture, Japan, and have been issued with a Physicall y Disabled Person's Certificate.In total, 114 dysvascular amputees, re presenting 58.2% of all lower limb amputations performed in the reside nt population during the study period, were surveyed. The underlying d isagnosis was arteriosclerotic obstruction in 64.9% of the subjects, d iabetic gangrene in 22.8%, acute embolism in 7.0% and Buerger's diseas e in 5.3%. The yearly incidence of new dysvascular amputees per 100,00 0 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 amputatio n, 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 surv ived 3 years postoperatively, 10 (27.8%) were fitted with prosthetic l imbs.