Title : Temporal analysis of the epidemiology of upper extremity amputations in the United States: An analysis of the global burden of disease database from 1990-2019
Abstract:
Background: Upper extremity amputations are devastating injuries on medical, psychological, and functional levels alike. To better understand their epidemiology, this study aimed to evaluate the region- and sex-specific differences of both unilateral and bilateral upper extremity amputations across the United States (U.S.) from 1990 – 2019.
Methods: The Global Burden of Disease database was utilized to collect epidemiological data pertaining to upper extremity amputations in the U.S. from 1990 – 2019. This data included years lived with disability (YLDs), prevalence rates, and incidence rates per 100,000 people. Using the U.S. Census Bureau definitions, the data was stratified into four regions: the Northeast, the Midwest, the South, and the West. Differences in YLDs, prevalence, and incidence rates between regions and between sexes were evaluated. Statistical significance was defined as p<0.05.
Results: From 1990-2019, the U.S. saw a 34.51% decrease in YLDs, 34.34% decrease in the prevalence, and a 37.38% decrease in the incidence of unilateral upper extremity amputations. In addition, the U.S saw a 51.32% decrease in YLDs, 48.94% decrease in the prevalence, and 56.80% decrease in the incidence of bilateral upper extremity amputations. Nationally, men were more likely to experience higher rates of YLDs, prevalence, and incidence of unilateral UEAs (p<0.001). Regional analysis demonstrated that the northeast region demonstrated the highest overall mean YLDs, prevalence and incidence of upper extremity amputations, whereas the south region experienced the lowest rates. Men were more likely to experience higher YLDs, prevalence, and incidence of unilateral and bilateral upper extremity amputations in each of the regions compared to women (p<0.05).
Conclusions: From 1990 to 2019, the U.S. experienced a decrease in the YLDs, prevalence, and incidence of upper extremity amputations. Men experienced higher rates than women across each region. The northeast had the highest overall rates, while the south had the lowest. These trends highlight significant gender and regional disparities in the impact of upper extremity amputations.
