What is the prevalence of upper extremity limb loss and deficiency
(the total number of individuals missing at least part of an arm
through incident or congenitally) in the US and worldwide?
Let me begin by saying that based on the research that I have done
that I think that the answer to the US part of the question is that
there are probably something like the 1.8 million amputees in the US
claimed by Johns Hopkins as conveyed to me by the ACA (see below, not
all that different from the 1.6 cited here
http://www.amputee-coalition.org/fact_sheets/amp_stats_cause.html) and
that upper-extremity amputees likely represent less than 10% of
these--maybe 100,000, although I have seen figures as low as 50,000.
A lot of claims are made about these statistics that do not cite
sources, wildly vary and cannot be correct (e.g. that 1:4 amputees is
missing an upper extremity,
(http://www.aboutonehandtyping.com/statistics.html), while it is
likely less than 1:10; that there are 3 million amputees in the US
when there are likely less than 2
(http://www.amputee-online.com/amputee/newamp.html. This site has an
interesting graphic that categorizes percentages of amputees at levels
of amputation, but does not cite the source), that there are about
387,500 amputees in the US,
(http://www.nupoc.northwestern.edu/pros_info.shtml), etc.)
An interesting summation of health statistics breaks down information
on the incidence of amputation or limb deficiency through an analysis
of hospital discharges, but breaks down the statistics by cause, and
does not make conclusions about prevalence in the population:
http://www.medscape.com/viewarticle/444327 (requires registration).
I received the below response from the Amputee Coalition of America to
a query about this issue that included the last link above as well as
a summary of the statistics it contained, but was unable to find a
good estimate of the upper-extremity amputee population.
As far as worldwide statistics are concerned, there are many countries
with landmine problems (Vietnam, Cambodia) and some with social issues
(Sierra Leone, with many victims of deliberate arm amputation) that
might skew statistics in one direction or another, but no reliable
information that I could find. Most information about amputees in the
developing world understandably focuses on the lower-extremity victims
of landmines.
In any case, what I am interested in is reliable numbers for these two
populations (US and worldwide) of upper-extremity amputees/limb
deficiencies that represent better than an educated guess or an
extrapolation, with academically citable reference(s).
Thanks, and I look forward to my answer.
Response from the ACA:
Thanks for contacting the Amputee Coalition of America (ACA).
Here are links to ACA's statistical fact sheets and an article that has
proven valuable to us and others seeking numbers for etiology and
amputation level.
NLLIC ACA fact sheet: Amputation Statistics by Cause:Limb Loss in the
United States
http://www.amputee-coalition.org/fact_sheets/amp_stats_cause.html
NLLIC ACA fact sheet: Diabetes and Lower Extremity Amputations
http://www.amputee-coalition.org/fact_sheets/diabetes_leamp.html
Limb Amputation and Limb Deficiency: Epidemiology and Recent Trends in
the United States
http://www.medscape.com/viewarticle/444327
As for the exact number of upper and lower limb amputations in the last
10 years, you can search by procedure codes (ICD-9-CM codes [Internal
Classification of Diseases, 9th Revision, Clinical Modification]) at
HCUPnet, an online database of hospital discharge data primarily
retrieved from the Nationwide Inpatient Sample (NIS)----currently over
1,000 hospitals. The following link gives you the codes you will need to
search HCUPnet:
http://icd9.chrisendres.com/index.php?srchtype=procs&srchtext=amputation
&Submit=Search&action=search. Codes 84.00 (upper limb amputations not
otherwise specified) and 84.10 (lower limb amputations not otherwise
specified) are the codes that should prove most useful to you and your
inquiry. If the data that you seek is not available in the database, you
may purchase raw NIS data from HCUPnet's central distributor
(http://www.hcup-us.ahrq.gov/tech_assist/centdist.jsp), beginning with
data from 1988 through 2003.
Also, you may want to familiarize yourself with the National Center for
Health Statistics (a program of the CDC). They have numerous reports
that document amputation statistics, some more so than others. However,
the CDC stopped including amputation statistics in most of their series
reports produced after 1997 (this is why the most recent source date for
the numbers we use in our fact sheet is 1997). We are currently working
with the CDC to begin including these numbers again, either in their
Series 10, 13, or 16 reports or as an annual special report.
And, finally, Johns Hopkins University has made us aware that the new
number of amputees residing in the US is now 1.8 million. This number is
legit, but at the moment there is not a study that you can source. We
assume the study will be released sometime this year.
Below, we have also included links to other federal entities that offer
information specific to disability statistics:
Links of Interest
http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi Kaiser State
Health Facts
http://www.fedstats.gov/ Federal Statistics
http://www.census.gov/hhes/www/disability/disability.html Census Bureau
Disability Reports
http://www.cdc.gov/nchs/ National Center for Health Statistics
http://www.ahrq.gov/ Agency for Healthcare Research and Quality
http://www.nahdo.org/default.asp National Association of Health Data
Organizations
http://www.ilr.cornell.edu/ped/DisabilityStatistics/ Disability
Statistics at Cornell University
http://www.diabetes.org/diabetes-statistics/national-diabetes-fact-sheet
.jsp National Diabetes Fact Sheet from ADA
http://www.armymedicine.army.mil/news/medevacstats/200504/oif.htm US
Army Medical Department
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi PubMed
We hope that you find this information useful to your inquiry. Please
let us know if we can be of further assistance.
Jim Myers
Information Specialist
National Limb Loss Information Center
Amputee Coalition of America
900 East Hill Avenue, Suite 285
Knoxville, TN 37915-2568
888-267-5669 ext. 8137
jmyers@amputee-coalition.org
Now Available! The 4th edition of ACA's award-winning publication, First
Step - A Guide for Adapting to Limb Loss. |
