Comparison of Transtibial Amputations in Diabetic Patients With and Without End-Stage Renal Disease

Wukich, Dane K.; Ahn, Junho; Raspovic, Katherine M.; Gottschalk, Frank; Fontaine, Javier La; Lavery, Larry A.

doi:10.1177/1071100716688073

Cited by 49 publications

(34 citation statements)

References 33 publications

(51 reference statements)

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“…In other words, rather than continued efforts to salvage a foot that is biomechanically nonfunctional, patients may function better with a below-knee amputation and a well-fitting prosthesis. The ability to ambulate with a prosthesis after transtibial amputation is associated with higher quality of life and reduced mortality (7,41). Using a Cox proportional hazards model, the mortality rate was reduced by 62% in patients with diabetes who ambulated after transtibial amputation compared with those who did not ambulate (7).…”

Section: The Impact Of Dfd On Hrqolmentioning

confidence: 99%

“…The ability to ambulate with a prosthesis after transtibial amputation is associated with higher quality of life and reduced mortality (7,41). Using a Cox proportional hazards model, the mortality rate was reduced by 62% in patients with diabetes who ambulated after transtibial amputation compared with those who did not ambulate (7). Patients who ambulated after transtibial amputation were six times more likely to demonstrate improvement in quality of life compared with those who did not ambulate (41).…”

Section: The Impact Of Dfd On Hrqolmentioning

confidence: 99%

“…Compared with the normal population, patients with CN or DFUs have a reduced life expectancy of 14 years (6). CN, DFU, infection, and ischemia often coexist in patients with DFD, increasing the risk of hospitalization and the need for amputation (7). Outcomes have been reported on a consecutive series of 102 patients who underwent transtibial amputation (7).…”

mentioning

confidence: 99%

“…CN, DFU, infection, and ischemia often coexist in patients with DFD, increasing the risk of hospitalization and the need for amputation (7). Outcomes have been reported on a consecutive series of 102 patients who underwent transtibial amputation (7). At a mean follow-up of 109 weeks, contralateral foot problems developed in 34% of patients, and 10% of patients ultimately required a contralateral transtibial amputation.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Assessing Health-Related Quality of Life in Patients With Diabetic Foot Disease: Why Is It Important and How Can We Improve? The 2017 Roger E. Pecoraro Award Lecture

Wukich

Raspovic

2018

Diabetes Care

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Patient-reported outcomes (PROs) have become an important subject in the area of diabetes-related foot complications. Self-reported health-related quality of life (HRQOL) surveys can provide a generic measure of overall health (global) and can be disease specific (i.e., diabetes) or even region specific (i.e., lower-extremity function). Analysis of PRO measures utilizing validated instruments allows health care providers to determine whether medical and surgical treatments are providing patients with the highest level of outcome possible and are actually improving HRQOL. The 36-item Short Form (SF-36), EuroQol five-dimension questionnaire (EQ-5D-5L), and Foot and Ankle Ability Measure (FAAM) are examples of commonly used HRQOL surveys. Low HRQOL has been associated with higher rates of hospital admission and mortality in patients with diabetes. Previous studies have demonstrated that patients with diabetes-related foot disease have low self-reported physical quality of life but do not typically report low mental quality of life. The impact of mental quality of life may be underestimated in these patients using the SF-36. In this article, we will discuss several widely used outcome instruments used to measure patient HRQOL and the impact of diabetic foot disease on HRQOL. As health care providers, we must continue to adjust and modify our treatments to achieve the best patient outcomes and associated high quality of life. Assessing PROs will become increasingly important as health care systems transition from a volume-based reimbursement model to a value-based model.

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Section: The Impact Of Dfd On Hrqolmentioning

confidence: 99%

Section: The Impact Of Dfd On Hrqolmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Assessing Health-Related Quality of Life in Patients With Diabetic Foot Disease: Why Is It Important and How Can We Improve? The 2017 Roger E. Pecoraro Award Lecture

Wukich

Raspovic

2018

Diabetes Care

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“…37 Five-year mortality rates are as high as 45% for neuropathic ulcers and 55% for ischemic ulcers. 32 These rates have been shown to be similar or worse than many common types of cancers, including prostate, breast, and colon 21,22,48 ( Figure 1). In addition to the morbidity of diabetic foot disease, there are major socioeconomic implications associated with this disease.…”

Section: Introductionmentioning

confidence: 96%

The Evaluation and Treatment of Diabetic Foot Ulcers and Diabetic Foot Infections

Core

Ahn

Lewis

et al. 2018

Foot & Ankle Orthopaedics

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Diabetic foot ulcers and infections are common complications of diabetic foot disease. Additionally, these complications are a common cause of morbidity and impose a substantial burden to the patient and society. It is imperative to understand the major contributing factors, namely, diabetic neuropathy, peripheral arterial disease, and immune system dysfunction in order to guide treatment. Management of diabetic foot disease begins with a detailed history and thorough physical examination. This examination should focus on the manifestations of diabetic neuropathy and peripheral arterial disease, and, in particular, any evidence of diabetic foot ulcers or infection. Prevention strategies should include a multi-disciplinary approach centered on patient education.

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Rehabilitation of the Amputee

Kowalske

Klakeel

2020

The Foot in Diabetes

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Comparison of Transtibial Amputations in Diabetic Patients With and Without End-Stage Renal Disease

Abstract: Level III, retrospective case controlled study.

Cited by 49 publications

References 33 publications

Assessing Health-Related Quality of Life in Patients With Diabetic Foot Disease: Why Is It Important and How Can We Improve? The 2017 Roger E. Pecoraro Award Lecture

Assessing Health-Related Quality of Life in Patients With Diabetic Foot Disease: Why Is It Important and How Can We Improve? The 2017 Roger E. Pecoraro Award Lecture

The Evaluation and Treatment of Diabetic Foot Ulcers and Diabetic Foot Infections

Rehabilitation of the Amputee

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