Table 1

Table showing the method details and outcomes extracted from the included articles

ArticleCountryCase data sourceExclusionsMLEA definitionStandardisationStatisticStudy periodStatistic value (95% CI where available)
General population
 Ahmad et al29
 		EnglandHESAge <50 and >84 yearsProximal to the ankleAgeIncidence proportion2003–2008*26
 Ahmad et al10EnglandHESAge <50 and >84 yearsProximal to the ankleAgeIncidence proportion2003–2008*26.3 (26 to 26.6)
 Ahmad et al7EnglandHESAge <50 and >84 yearsProximal to the ankleAgeIncidence proportion2003*
2004*
2005*
2006*
2007*
2008*
2009*
2010*
2011*
2012*		27.7
27.7
26.6
25.3
26.0
26.8
25.3
25.1
23.7
22.9
 Ambler et al30UKNVRNoneBKA/TKA/AKA/hip disarticulation/hind quarterN/ANumber2014–20169549
 Behrendt et al4
 		EnglandHESTrauma, cancerProximal to the ankleNoneIncidence proportion
(PAD related amputations)		2010
2011
2012
2013
2014		9.5
9.1
8.6
8.7
8.2
 Kennon et al
 37		ScotlandSMR01Trauma, cancerThrough/proximal to the ankleNoneIncidence proportion
(Diabetes related amputations)		2004
2005
2006
2007
2008		6.73 (6.06 to 7.49)
5.06 (4.48 to 5.72)
5.28 (4.68 to 5.94)
5.05 (4.48 to 5.71)
4.43 (3.89 to 5.04)
 Moxey et al
 9		EnglandHESNoneBKA/TKA/AKANoneIncidence proportion2003–2007*51.1
 Moxey et al
 38		EnglandHESAge <50 and >84 years, trauma, cancerBKA/TKA/AKAN/ANumber2002–2005*14 168
 Nickinson et al
 39		EnglandHES linked CPRDAge <17 years, trauma, cancerProximal to the ankleN/ANumber2000 –
2016		3260
 NVR report
 201546		UKNVRBilateralBKA/AKAN/ANumber20142465
 NVR report
 201647		UKNVRTrauma, bilateral MLEABKA/AKAN/ANumber2014–20155318
 NVR report
 201748		UKNVRTrauma, bilateral MLEABKA/AKAN/ANumber2014–20168866
 NVR report
 201849		UKNVRTrauma, bilateral
MLEA		BKA/AKAN/ANumber2015–20179293
 NVR report
 201922		UKNVRTrauma, bilateral MLEABKA/AKAN/ANumber2016–20189508
 NVR report
 202040		UKNVRTrauma, bilateral MLEABKA/TKA/AKAN/ANumber2017–201910 022
 Staniszewska et al
 42		EnglandHESNone‘Major amputation' not further definedN/ANumber2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018		5418
5334
5208
4864
4881
4804
4542
4829
4973
4994
5004
4638
4608
4526
4473
4573
4735
4742
4907
 Vamos et al44
 		EnglandHESTraumaThrough/proximal to the ankleNoneIncidence proportion
(people without diabetes†)		2004*
2005*
2006*
2007*
2008*		7.7
7.5
6.8
7.1
6.9
 Vamos et al
 45		EnglandHESTraumaThrough/proximal to the ankleAge, sexIncidence proportion
(people without diabetes†)		1996*
1997*
1998*
1999*
2000*
2001*
2002*
2003*
2004*
2005*		7.0
6.8
6.8
6.7
6.2
6.2
5.7
5.4
5.1
4.9
Population with diabetes
 Gunn et al
 31		EnglandHES, CPRDAge <18 years, previous LEA, non-type 2 diabetes, censored prior to 1 April 2011‘Major amputation’ defined by code listNoneIncidence rate2010–2017*Type 2 diabetes
96
 Holman et al
 8		EnglandHESAge <17 yearsProximal to the ankleNoneIncidence rate2007–2009*99
 Kennon et al
 37		ScotlandSMR01Trauma, cancerThrough/proximal to the ankleNoneIncidence proportion2004
2005
2006
2007
2008		187 (168 to 207)
134 (119 to 151)
135 (120 to 152)
126 (112 to 142)
111 (99 to 126)
 NDA
 2009–2 0143		EnglandHESNone‘Major amputation' not further definedNoneIncidence proportion2009*70
 NDA
 2010–2 0132		England and WalesHES, PEDWNoneBKA/TKA/AKAAge, sexIncidence proportion2010*291
 NDA
 2011–2 0133		England and WalesHES, PEDWNoneBKA/TKA/AKANoneIncidence proportion2010–2011*170
 NDA
 2012–2 0134		England and WalesHES, PEDWNoneBKA/TKA/AKANoneIncidence proportion2012*70
 NDA
 2015–2 0136		England and WalesHES, PEDWNone‘Major amputation' not further definedNoneIncidence proportion2015*75
 NDA
 2017–2 0135		England and WalesHES, PEDWNone‘Major amputation' not further definedNoneIncidence proportion2017*73
 PHE Fingertips
 202041		EnglandHESAge <17 yearsProximal to the ankleAge, ethnicityIncidence proportion
(/rate)‡		2017–2019*82 (81 to 84)
 Vamos et al
 44		EnglandHESTraumaThrough/proximal to the ankleNoneIncidence proportion2004*
2005*
2006*
2007*
2008*		118
106
97
100
102
 Vamos et al
 45		EnglandHESTraumaThrough/proximal to the ankleAge, sexIncidence proportion1996*
1997*
1998*
1999*
2000*
2001*
2002*
2003*
2004*
2005*		Type 1 diabetes
1.3
1.4
1.5
1.4
1.1
1.2
1.1
0.9
0.9
0.7		Type 2
diabetes
2.0
2.1
2.1
2.3
2.3
2.4
2.6
2.6
2.7
2.7

  • Statistic value is presented as incidence proportion per 100 000 population, incidence rate per 100 000 person years or total number where a calculated statistic was not reported. If both standardised and crude values were available, the standardised value has been presented. Where outcome measures were given for the population with diabetes by type, these are specified in the table.

  • *Study period conducted over the financial year (April–March) rather than the calendar year.

  • †Incidence proportion of people without diabetes rather than the general population (which includes those with diabetes).

  • ‡Statistic definition unclear in report.

  • AKA, above knee amputation; BKA, below knee amputation; CPRD, clinical practice research datalink; HES, Hospital Episode Statistics; LEA, lower extremity amputation (minor and major); NDA, National Diabetes Audit; NVR, National Vascular Registry; PEDW, Patient Episode Database for Wales; PHE, Public Health England; SMR01, Scottish morbidity records; TKA, through knee amputation.