Incidencia de amputaciones de extremidades inferiores en el área 3 de Madrid. Estudio retrospectivo del periodo 2001–2006

Rubio, José António; Salido, Carmen Pozo; Albarracín, Agustín; Jiménez, Sara; Alvarez, Josefina

doi:10.1016/j.rce.2009.06.010

Cited by 17 publications

(9 citation statements)

References 9 publications

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“…2 However, these data are exceptional rather than being typical of Spain. Our group reported a high rate of LEAs in our area, 3 and other Spanish teams have also reported higher rates. 4,5 Furthermore, López-de-Andrés et al recently reported an increase, over the whole of Spain, in major and minor amputations in patients with type 2 diabetes between 2001 and 2008.…”

supporting

confidence: 67%

Reducing Major Lower Extremity Amputations After the Introduction of a Multidisciplinary Team for the Diabetic Foot

Rubio

Aragón‐Sánchez

Jiménez

et al. 2014

The International Journal of Lower Extremity Wounds

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We analyzed the incidence of lower extremity amputations (LEAs) in the 3rd Health Care Area of Madrid before and after the March 2008 introduction of a multidisciplinary team for managing diabetic foot disease. We compared the amputation rates in people with and without diabetes during 2 periods: before (2001-2007) and after (2008-2011) the introduction of a Multidisciplinary Diabetic Foot Unit (MDFU). We also analyzed the trend of the amputation rates by joinpoint regression analysis and measured the annual percentage change (APC). During the study period, 514 nontraumatic LEAs were performed, 374 (73%) in people with diabetes and 140 (27%) in people without the disease. The incidence of LEAs showed a significant reduction in major amputations in people with diabetes, from 6.1 per 100 000 per year (95% confidence interval [CI] = 4.9 to 7.2), in the 2001 to 2007 period, to 4.0 per 100 000 per year (95% CI = 2.6 to 5.5) in the 2008 to 2011 period (P = .020). There were no changes in incidence of minor or total amputations in the diabetic population or in amputations in the nondiabetic population during the study period. Joinpoint regression analysis showed a significant reduction in the incidence of major LEAs in diabetic population with an APC of -6.6% (95% CI = -10.2 to -2.8; P = .003), but there were no other significant changes. This study demonstrates that the introduction of a multidisciplinary team, coordinated by an endocrinologist and a podiatrist, for managing diabetic foot disease is associated with a reduction in the incidence of major amputations in patients with diabetes.

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supporting

confidence: 67%

Reducing Major Lower Extremity Amputations After the Introduction of a Multidisciplinary Team for the Diabetic Foot

Rubio

Aragón‐Sánchez

Jiménez

et al. 2014

The International Journal of Lower Extremity Wounds

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“…Other Spanish regional studies (13,14) indicated that LEA rates in populations with or without diabetes are higher than previously reported; however, national population-based data on trends in LEAs in Spain are lacking.…”

Section: Discussionmentioning

confidence: 70%

Trends in Lower-Extremity Amputations in People With and Without Diabetes in Spain, 2001–2008

et al. 2011

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OBJECTIVETo examine trends in nontraumatic lower-extremity amputations (LEAs) over an 8-year period in patients with and without diabetes in Spain.RESEARCH DESIGN AND METHODSWe identified all patients who underwent an LEA using national hospital discharge data. Discharges were grouped by diabetes status: type 1 diabetes, type 2 diabetes, and no diabetes. The incidence of discharges attributed to amputations were calculated overall and stratified by diabetes status and year. We calculated length of stay and in-hospital fatality stratified by diabetes status and type of LEA.RESULTSFrom 2001 to 2008, 46,536 minor LEAs and 43,528 major LEAs were performed. In patients with type 1 diabetes, the incidence of minor and major amputations decreased significantly from 2001 to 2008 (0.88–0.43 per 100,000 inhabitants and 0.59–0.22 per 100,000 inhabitants, respectively). In patients with type 2 diabetes, the incidence of minor and major LEAs increased significantly (9.23–10.9 per 100,000 inhabitants and 7.12–7.47 per 100,000 inhabitants). Hospital stay was similar among type 1 diabetic and type 2 diabetic subjects, according to the type of LEA. Only in-hospital mortality for minor LEAs among type 1 diabetic subjects decreased significantly (4.0% in 2001 vs. 1.6% in 2008).CONCLUSIONSOur national data show a decrease in the incidence of major and minor LEAs in patients with type 1 diabetes and an increase among patients with type 2 diabetes. Further improvement is necessary in the preventive care and early treatment of patients with diabetes. The management of foot lesions, especially among type 2 diabetic patients, is particularly urgent.

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“…For developing countries, reported incidence rates for LEA secondary to diabetes vary from 13.7 to as high as 18.0 per 1 000 PY, as reported in studies conducted in the 1990s among Pima Indians (32,33). In developed countries, the rates range from 1.7 to 2.9 (3,(34)(35)(36)(37).…”

Section: Discussionmentioning

confidence: 92%

Diabetes-related lower-extremity amputation incidence and risk factors: a prospective seven-year study in Costa Rica

Laclé¹,

Juan²

2012

Rev Panam Salud Publica

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Those most likely to undergo LEA among Costa Rican diabetic patients were men with 10 or more years of diabetes and average HbA1c > 8% who used insulin and had diabetic retinopathy. Patients on insulin therapy were at greatest risk, especially those with a previous amputation. Diabetic patients with the above-mentioned profile should be considered to be at very high risk of LEA and followed closely by the health care system.

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Incidencia de amputaciones de extremidades inferiores en el área 3 de Madrid. Estudio retrospectivo del periodo 2001–2006

Cited by 17 publications

References 9 publications

Reducing Major Lower Extremity Amputations After the Introduction of a Multidisciplinary Team for the Diabetic Foot

Reducing Major Lower Extremity Amputations After the Introduction of a Multidisciplinary Team for the Diabetic Foot

Trends in Lower-Extremity Amputations in People With and Without Diabetes in Spain, 2001–2008

Diabetes-related lower-extremity amputation incidence and risk factors: a prospective seven-year study in Costa Rica

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