Survival of diabetes patients with major amputation is comparable to malignant disease

Abstract

Introduction: Almost all studies on diabetic foot syndrome focused on prevention of amputation and did not investigate long-term prognosis and survival of patients as a primary outcome parameter. Methods:We did a retrospective cohort study including 314 patients who had diabetic foot syndrome and underwent amputation between December 1995 and January 2001. Results: A total of 48% of patients received minor amputation (group I), 15% only major amputation (group II) and 36% initially underwent a minor amputation that was followed by a major amputation (group III). Statistically significant differences were observed in comparison of the median survival of group I to group II (51 vs 40 months; p = 0.016) and of group II to group III (40 vs 55 months; p = 0.003). Discussion: The prognosis of patients with major amputation due to diabetic foot syndrome is comparable to patients with malignant diseases. Vascular interventions did not improve the individual prognosis of patients.

Predictors of in-hospital mortality following major lower extremity amputations in type 2 diabetic patients using artificial neural networks

“…Despite having lower incidence rates of major LEAs several studies, including ours, suggest that women have higher mortality rates associated with diabetes-related LEAs [36, 37]. In US have reported that women had higher IHM associated with diabetes-related LEAS (37.7 IHM/1000 amputations vs. 29.7/1000 amputations [38].…”

“…Patients who needed major amputations suffered from a more severe cardiovascular disease than others [36]. Previous studies in Spain, significant risk factors for IHM were cardiac and respiratory complications and first episode of amputation [41].…”

“…Different studies have identified renal disease as a risk factor for a significantly lower long-term survival after a major LEA [6, 36, 43–46]. Recently, Assi et al reported that patients with chronic kidney disease have higher risk (OR 2.27; 95% CI 1.02–5.06) of postoperative long-term mortality and concluded that how CKD contributes to worse survival is unclear [31].…”

Trends in the epidemiology of diabetic foot and lower limb amputations in Russian Federation according to the Federal Diabetes Register (2013–2016)

“…Между тем немногочисленные ис-следования данного показателя, отмечают, что прогноз выживания пациентов с СДС, особенно после ампута-ций нижних конечностей значительно хуже, чем у онко-логических больных [2]. Следует отметить, что прогноз жизни зависит от уровня ампутаций; так, средний срок выживания в группе пациентов с СД с малыми ампута-циями составил 51 мес, что оказалось достоверно боль-ше, чем в группе пациентов с высокими ампутациями, -40 мес (p=0,016) [3]. При этом по стоимости лечения СДС представляет одну из наиболее затратных патологий.…”

Negative pressure wound therapy use in diabetic foot syndrome—from mechanisms of action to clinical practice

“…Despite new therapeutic advances, many patients still develop various forms of DFS at different stages. DFS is associated with a high rate of amputation and excessive mortality . It was estimated that every minute, two lower limbs or parts of a lower limb are lost somewhere in the world as a consequence of DFS .…”