Analysis of 19 439 lower limb amputations in children in Brazilian health system over 14 years.

IF 2.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Injury Prevention Pub Date : 2025-01-07 DOI:10.1136/ip-2024-045472
Felipe Soares Oliveira Portela, Andressa Cristina Sposato Louzada, Marcelo Fiorelli Alexandrino da Silva, Maria Fernanda Cassino Portugal, Fernando Ayroza Galvão, Marcelo Passos Teivelis, Edson Amaro Junior, Nelson Wolosker
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Abstract

Background: Amputations in children represent significant events. Few studies analyse amputations in this specific population, and most of them are old, regionalised and with small sample sizes. Besides, there are no large studies in low-income and middle-income countries. This study aims to analyse a large sample of amputations (19 439 procedures performed in the Brazilian public health system) in children aged 0-14 over 14 years.

Methods: Retrospective cross-sectional population-based analysis of all lower limb amputations performed in the Brazilian public health system between 2008 and 2021 in children up to 14. Using a public database, all types of amputations were selected, defining the number of procedures, their main aetiologies, trends over the years, patient demographics and regional distribution.

Results: 19 439 lower limb amputations were performed in the Brazilian public health system between 2008 and 2021, mainly at the toe level (85%). Amputations occurred predominantly in males (64%) and children aged 0-4 (47%). The global trend is a non-significant decrease in the total number of amputations over the period (p=0.427), but we observe a significant decrease (p<0.001) in amputations in older children (aged 10-14). Amputations are more concentrated in the most populated regions, while the highest mortality is found in the least densely populated areas. Trauma is the main aetiology associated with lower limb amputations in Brazilian children (60%).

Conclusion: The epidemiology of amputations in Brazil differs from the rest of the world. Trauma is the main aetiology.

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巴西卫生系统14年来19 439例儿童下肢截肢分析
背景:儿童截肢是重大事件。很少有研究分析这一特定人群的截肢,而且大多数研究都是年老的、区域化的、样本量小。此外,在低收入和中等收入国家也没有大规模的研究。本研究旨在分析14岁以上0-14岁儿童截肢的大样本(巴西公共卫生系统实施的19439例手术)。方法:对2008年至2021年间巴西公共卫生系统中14岁以下儿童进行的所有下肢截肢进行回顾性横断面人群分析。使用公共数据库,选择所有类型的截肢,确定手术数量,主要病因,多年来的趋势,患者人口统计和区域分布。结果:2008年至2021年间,巴西公共卫生系统共进行了19 439例下肢截肢手术,主要是足趾截肢(85%)。截肢主要发生在男性(64%)和0-4岁儿童(47%)。全球趋势是在此期间截肢总数无显著减少(p=0.427),但我们观察到显著减少(p结论:巴西截肢流行病学与世界其他地区不同。创伤是主要的病因。
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来源期刊
Injury Prevention
Injury Prevention 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.30
自引率
2.70%
发文量
68
审稿时长
6-12 weeks
期刊介绍: Since its inception in 1995, Injury Prevention has been the pre-eminent repository of original research and compelling commentary relevant to this increasingly important field. An international peer reviewed journal, it offers the best in science, policy, and public health practice to reduce the burden of injury in all age groups around the world. The journal publishes original research, opinion, debate and special features on the prevention of unintentional, occupational and intentional (violence-related) injuries. Injury Prevention is online only.
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