Incidence and Hospitalization Costs of Lower Extremity Amputations in Patients with Diabetes During 2015–2020: A Regional Retrospective Observational Study from Sweden

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Background: Diabetes mellitus (DM)-related amputations impose a substantial burden on individuals and healthcare systems. This study aimed to assess the incidence of amputations at different levels (hip and femur, knee and below knee, foot and ankle) and the associated hospitalization costs in the Västra Götaland region (VGR), Sweden. Methods: This retrospective observational study analyzed data from the VEGA database covering approximately 1.8 million inhabitants during the six-year period (2015–2020). Incidence rates and hospitalization costs were calculated using inpatient hospital records and patient-level cost data provided according to the principles of the Swedish Association of Local Authorities and Regions (SALAR). Results: A total of 1794 amputations were performed (mean 299 per year). Knee and below-knee amputations were the most common (118/year), followed by foot and ankle (98/year), and hip and femur (82/year). The mean annual hospitalization cost was approximately 64 million SEK (6.4 million euro). Overall, 2% of individuals with DM underwent an amputation during the study period, with men accounting for more amputations than women (1210 vs. 584 amputations). Foot and ankle amputations were proportionally more common among men (0.9%). Conclusions: Lower extremity amputations among patients with DM remain common and are associated with substantial healthcare costs. Strengthened preventive strategies, particularly those targeting foot health and high-risk groups such as men, are needed to reduce the burden of amputations.

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