300 Section - Trend of the incidence of non-traumatic limb surgical amputations from 2009 to 2018: a nationwide database study in South Korea

Objectives : To investigate nationwide trends in the incidence, surgical indications, and patient demographics of non-traumatic limb amputations in South Korea.

Design: The population-based retrospective study analyzed nationwide claims data from the Korean National Health Insurance System. Patients who underwent non-traumatic limb amputation during hospitalization between 2009 and 2018 were identified. Surgical indications were categorized as diabetes mellitus (DM), peripheral artery disease (PAD), acute limb ischemia (ALI), infection, or cancer. Annual incidence rates were calculated using the median population, and temporal trends were evaluated using joinpoint regression to estimate annual percentage changes (APC).

Results: A total of 48,067 patients underwent amputation (73.46% minor, 26.54% major) during the study period. The overall incidence significantly increased (APC: 2.25%, p< 0.05), driven by minor amputations (APC: 3.65%, p< 0.05), while major amputations declined (APC: -1.41%, p< 0.05). DM was the most common indication (76.25%), followed by PAD (37.83%) and infection (33.83%). The proportion of DM increased in both major and minor amputation. The proportion of medical beneficiaries was significantly higher(17.76% of all amputations, 22.68% of major amputations, and 15.99% of minor amputations) and increased over study period.

Conclusion: Non-traumatic amputations have increased in Korea over the past decade, with a notable rise in minor amputations and diabetes as the predominant indication. These findings underscore the need for proactive chronic disease management and preventive interventions, particularly among socioeconomically vulnerable populations.