Risk Factors for Premature Death in Diabetes Patients who Undergo Amputations below Ankle Level

Wilbek, T. E.; Jansen, Rasmus Bo; Jørgensen, Bo; Svendsen, Ole Lander

doi:10.1055/s-0043-109700

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…The statistically significantly lower long-term survival rate we observed among the older subjects who underwent amputations in our study cohort had also been previously reported in other studies, 13,[17][18][19] although some other researchers did not find this association. 15,17 Although we did not find any statistically significant difference between minor and major amputations on long-term survival, other workers reported lower survival rates associated with major amputations.…”

Section: Discussionsupporting

confidence: 90%

“…There is wide discrepancy in the long-term survival rates among different cohorts of patients reported from various regions of the world owing to the study characteristics evaluated in the subjects studied. 10,13,[15][16][17][18] For instance, we observed a 10+ year survival rate of 24% in our cohort, while McEwen. et al 10 and López-de-Andrés.…”

Section: Discussionsupporting

confidence: 42%

“…et al, 17 and Wilbek. et al 18 were 61%, 55.5%, 30%, 40% and 58% respectively. Co-morbid disease states and cardiovascular factors inherent to diabetic foot disease might explain these wide discrepancies in the survival rates.…”

Section: Discussionmentioning

confidence: 85%

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Survival at 10 years following lower extremity amputations in patients with diabetic foot disease

et al. 2020

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Background Amputations are associated with markedly reduced long-term survival in patients with diabetic foot disease. However, there is paucity of long-term survival data in published literature.Methods We searched the electronic case records and laboratory details of patients who underwent amputations between 1997 and 2006 to obtain at least 10 years of follow up data after the surgery to assess the survival rates and possible risk factors reducing survival in the year 2016. Amputation level below ankle was considered as minor and above ankle as major amputations.Results Of the 233 cases (159 males; median age 68 years), 161 had major amputations. Of the 72 cases who had minor amputations initially, 63 needed a further amputation or contralateral amputation on follow up. One hundred seventy-seven patients (76%) were not alive after 10 years of follow up. The survival rates at 1, 3, 5, 7, and ≥10 years were 64%, 50%, 40%, 34%, and 24%, respectively. Maximum number of deaths occurred within 4 months of amputations. There was no difference between survival rates following major or minor amputations and among males or females. The only statistically significant parameter affecting lower survival rate was age ≥70 years, with each additional year of age increasing the hazard by a factor of 1.039 (95% CI: 1.024-1.054) or 3.9% (2.4-5.4%).Conclusions Five-year and 10-year survival rates were 40% and 24%, respectively, following diabetic foot amputations. Higher age ≥70 years was associated with lower survival rate compared with younger age groups after lower extremity amputations.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 42%

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Survival at 10 years following lower extremity amputations in patients with diabetic foot disease

et al. 2020

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“…This paradoxical finding is probably attributable to the fact that the latter underwent revascularisation, which, in turn, promoted wound healing [13]. Indeed, subjects with biphasic waveforms failing to undergo revascularisation had a significantly higher non-healing rate, suggesting that optimised blood flow to the foot improved healing rates in this group [13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Healing and Mortality Rates Following Toe Amputation in Type 2 Diabetes Mellitus

Vassallo

Gatt

Cassar

et al. 2019

Exp Clin Endocrinol Diabetes

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Background and Aim This single-centre study aimed to determine healing, re-ulceration, re-amputation and mortality rates at one year after toe amputations in patients with type 2 diabetes (T2DM). Patients and Methods Eighty-one participants with T2DM admitted for toe amputation were included. Patient characteristics, peripheral circulation and neuropathy status were recorded. Subjects were then followed every 3 months post-amputation for a year. Results Overall, 59.3% of participants underwent further surgery (n=31 to revise the original amputation site and n=17 to amputate a new site). During 12 months, 45.7% of participants presented with a new ulcer at a different site. Mortality was 7.4%. In 12.4% of participants, the amputation site remained incompletely healed. Only 20.9% had no complications in 12 months. At 12 months, 80.2% of study cohort had a completely healed amputation site. Conclusion In conclusion, this study highlighted high re-intervention, re-amputation and new ulceration rates. Strategies to improves these outcomes in such high-risk patients are warranted.

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A meta-analysis of mortality after minor amputation among patients with diabetes and/or peripheral vascular disease

Yammine

Hayek

Assi

2020

Journal of Vascular Surgery

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Risk Factors for Premature Death in Diabetes Patients who Undergo Amputations below Ankle Level

Abstract: Short time from first admission to amputation is a risk factor for early death. Arterial insufficiency and high age is also associated with increased mortality, whereas use of statin is associated with decreased mortality, in patients with type 2 diabetes.

Cited by 3 publications

References 19 publications

Survival at 10 years following lower extremity amputations in patients with diabetic foot disease

Survival at 10 years following lower extremity amputations in patients with diabetic foot disease

Healing and Mortality Rates Following Toe Amputation in Type 2 Diabetes Mellitus

A meta-analysis of mortality after minor amputation among patients with diabetes and/or peripheral vascular disease

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