Mortality in diabetic and nondiabetic patients after amputations performed from 1996 to 2005 in a tertiary hospital population: a 3-year follow-up study

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• 作者：Athanasia Papazafiropoulou ; Nicholas Tentolouris ; Rigas-Philippos Soldatos ; Christos D. Liapis ; Eleftherios Dounis ; Alkiviadis G. Kostakis ; Elias Bastounis ; Nicholas Katsilambros
• 刊名：Journal of Diabetes and its Complications
• 出版年：2009
• 出版时间：January-February 2009
• 年：2009
• 卷：23
• 期：1
• 页码：7-11
• 全文大小：172 K

文摘

Aims

Diabetes is the leading cause of lower-extremity amputations worldwide. The objective of this study was to look at the survival after first amputation between subjects with and without diabetes in a sample of Greek population.

Method

We performed a retrospective study of all nontrauma, nonneoplasm–related amputations performed in a tertiary centre during the years 1996–2005 in diabetic (n=183) and nondiabetic patients (n=75). Survival status was assessed from the first amputation until December 31, 2005.

Results

A total of 54.6 % of amputees with diabetes and 51.6 % of those without diabetes died in a mean [95 % confidence interval (CI)] time of 4.3 (3.5–5.1) and 6.6 (4.6–8.6) years after the first amputation, respectively (P=.65). Diabetic patients underwent a second amputation (P=.003) and contralateral amputations (P=.02) more often in comparison with nondiabetic subjects. Predictors of all-cause mortality in the diabetic group, after adjustment for sex, were age [hazard ratio (HR) (95 % CI), 1.04 (1.02–1.06); P<.001] and the level of amputation (major vs. minor) [HR, 1.55 (1.00–2.40), P=.05]. The respective values in the nondiabetic patients were HR of 1.06 (1.03–1.08; P<.001) and HR of 3.12 (1.27–7.64; P=.01). Median length of hospital stay was comparable between the two groups.

Conclusion

Mortality rates after amputation were high in both patients with and without diabetes. Older age and a higher level of amputation were associated with poorer survival. Diabetic patients more often underwent a second amputation to the same and the contralateral limb. Additionally, mortality rates, length of hospital stay, and perioperative mortality were not different between patients with and without diabetes.