Time Trends in the Incidence of Long-Term Mortality in T2DM Patients Who Have Undergone a Lower Extremity Amputation. Results of a Descriptive and Retrospective Cohort Study.

Autor: López-de-Andrés A; Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, 28922 Madrid, Spain. ana.lopez@urjc.es., Jiménez-García R; Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain. rodrijim@ucm.es., Esteban-Vasallo MD; Madrid Regional Health Authority, Public Health Directorate, 28040 Madrid, Spain. maria.estebanv@salud.madrid.org., Hernández-Barrera V; Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, 28922 Madrid, Spain. valentin.hernandez@urjc.es., Aragon-Sánchez J; Department of Surgery, Diabetic Foot Unit, La Paloma Hospital, 35005 Las Palmas de Gran Canaria, Spain. javiaragon@telefonica.net., Jiménez-Trujillo I; Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, 28922 Madrid, Spain. isabel.jimenez@urjc.es., de Miguel-Diez J; Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28009 Madrid, Spain. javier.miguel@salud.madrid.org., Palomar-Gallego MA; Basic Science Department, Health Sciences Faculty, Rey Juan Carlos University, 28922 Madrid, Spain. mariaangustias.palomar@urjc.es., Romero-Maroto M; Medical Department, Health Sciences Faculty, Rey Juan Carlos University, 28922 Madrid, Spain. mromeromaroto.urjc@gmail.com., Perez-Farinos N; Department of Public Health and Psychiatry, Faculty of Medicine, Universidad de Malaga, 29071 Malaga, Spain. napoleon.perez@uma.es.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2019 Oct 02; Vol. 8 (10). Date of Electronic Publication: 2019 Oct 02.
DOI: 10.3390/jcm8101597
Abstrakt: (1) Background: The aims of this study were to examine the incidence of lower extremity amputations (LEAs) among patients with type 2 diabetes mellitus (T2DM) and to compare the mortality risk of diabetic individuals who underwent LEA with age and sex-matched diabetic individuals without LEA. (2) Methods: We performed a descriptive observational study to assess the trend in the incidence of LEA and a retrospective cohort study to evaluate whether undergoing LEA is a risk factor for long-term mortality among T2DM patients. Data were obtained from the Hospital Discharge Database for the Autonomous Community of Madrid, Spain (2006-2015). (3) Results: The incidence rates of major below-knee and above-knee amputations decreased significantly from 24.9 to 17.1 and from 63.9 to 48.2 per 100000 T2DM individuals from 2006 to 2015, respectively. However, the incidence of minor LEAs increased over time. Mortality was significantly higher among T2DM patients who underwent LEA compared with those who did not undergo this procedure (HR 1.75; 95% CI 1.65-1.87). Male sex, older age, and comorbidity were independently associated with higher mortality after LEA. (4) Conclusions: Undergoing a LEA is a significant risk factor for long term mortality among T2DM patients, and those who underwent a major above-knee LEAs have the highest risk.
Databáze: MEDLINE
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