Mortality of Diabetic Patients Treated Surgically for Lower Limb Infection and/or Gangrene

Abstract

A retrospective study was made to ascertain the mortality rate among 100 consecutive patients with diabetes mellitus who had undergone lower limb amputations for infection and/or gangrene in the combined medical-orthopedic service of a county hospital. The medical and orthopedic staffs functioned as equal members, and combined decision-making conferences were held regularly. The over-all mortality rate was 9 per cent, a substantial decrease from the 22 to 25 per cent previously reported in similar studies. The mortality rate among patients with below-knee procedures was 1 per cent versus the 7 to 9 per cent reported by others. Close medical-surgical liaison on a service specializing in the care of these often fragile patients with diffuse multisystem disease results in decreased mortality.

Diabetic amputees in Singapore.

“…The range varies from one week to thirty-two years. These data are comparable to those reported by investigators in the Western na tions5, 16,18,21) The principal reason for lower extremity amputation is undoubtedly ischae mia. Although neuropathy and susceptibility to infection contribute to the high rate of gangrene in diabetics, vascular disease is the major factor.…”

“…Others have reported similar findings5, 16,18,20) The diabetics, as a group, had their amputation about ten years earlier than the nondiabetic group who had amputation because of atherosclerosis. Like others, we report that amputation is uncommon in diabetics under forty years.…”

Morbidity after femoral neck fracture not increased in diabetics

“…Our study comparing the morbidity after operation for femoral neck fracture in patients with diabetes mellitus and in matched non-diabetic controls does not support previous retrospective studies without matched controls, suggesting an increased incidence of complications in diabetic patients (Cruse & Ford 1973, Kahn et al 1974). …”

“…Diabetes mellitus is usually considered to be a risk factor in surgical procedures (Cruse & Ford 1973, Kahn et al 1974). This conclusion has been based on retrospective series, in which matched non-diabetic control patients were not included.…”

Análise clínica e evolução de 70 casos de lesões podais infectadas em pacientes diabéticos

“…Neste estudo a taxa de óbitos foi de 15,7%; em concordância com outros autores (9-33%) (25,27,(39)(40)(41)(42)(43). Como na literatura (3,4), as internações foram prolongadas, com duração média de 38 dias.…”