Trends in diabetes-related lower-extremity amputation rates across OECD countries

Introduction: Diabetes-related lower-extremity amputation is a disabling and costly complication of diabetes, and reported rates differ markedly between countries. Methods: Ecological longitudinal analysis of the OECD Health Care Quality Indicators, using age-sex standardised rates of major and minor lower-extremity amputations per 100 000 population aged 15 years and over reported by 28 OECD countries between 2004 and 2023. Temporal trends were estimated with linear mixed models, and country-level change was measured from the earliest available year to 2023. Results: In 2023 the OECD mean rate of any lower-extremity amputation was 23.5 per 100 000, ranging from 2.8 in Iceland to 69.1 in Malta. Major amputations declined by −0.08 per 100 000 per year (95% CI −0.10 to −0.05), whereas minor amputations rose by 0.21 per 100 000 per year (95% CI 0.16-0.26). Chile increased from 14.6 in 2004 to 40.8 per 100 000 in 2023, a 179.5% increase. Conclusions: Diabetes-related amputation rates vary widely across OECD countries and show divergent trends, with major amputations declining and minor amputations rising. Chile exhibited the largest increase among countries with long time series.