Incidence and Risk Factors for Amputations in Persons with Diabetes Mellitus: A Retrospective Cohort Study.
| Autor: | Bandeira MA; School of Nursing at the University of Sao Paulo, Sao Paulo, Brazil., Macedo RN; Amico Saúde, São Paulo, SP, Brazil., Lázaro-Martinez JL; Complutense University of Madrid, Madrid, Espanha., Alvarez YG; Complutense University of Madrid, Madrid, Espanha., Rocha MNB; ConvaTec Inc, ConvaCare Clinics, São Paulo, São Paulo, Brazil., Santos VLCG; Department of Medical-Surgical Nursing, School of Nursing at the University of Sao Paulo in Sao Paulo, Sao Paulo, Brazil. |
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| Jazyk: | angličtina |
| Zdroj: | The international journal of lower extremity wounds [Int J Low Extrem Wounds] 2024 Nov 06, pp. 15347346241292377. Date of Electronic Publication: 2024 Nov 06. |
| DOI: | 10.1177/15347346241292377 |
| Abstrakt: | The aim of this study was to identify and analyze the incidence rate of amputations and their risk factors in people with Diabetes Mellitus (DM) in two specialized outpatient clinics in Brazil. This is an epidemiological, retrospective cohort study using data collected from electronic health records of 281 adult diabetic patient types 1 or 2; attended in specialized outpatient service between 2015 and 2020. Statistical analyses were performed using the 2 sample t-test or Wilcoxon-Mann-Whitney test, for quantitative variables, and the Pearson's χ2 test or Fisher's exact test for categorical variables. The investigation of the risk factors for amputation was carried out through logistic regression. The study was approved by ethical committee. The sample mean age was 65.6 years (SD 13.05), predominating male gender n = 211 (75%), type 2 DM n = 223 (86.7%), with cardiovascular disease n = 143 (63.2%), and about 68.7% (n = 156) with peripheral arterial disease (PAD). Seventy-seven had lower limb amputation (LLA), with a rate incidence of 31.9% during five years. Logistic regression analysis showed the following associations with amputation: Diabetic peripheral neuropathy increased the rate of amputation by 3.6 times (OR = 3.631, 95% CI = 1.214-11.353; P = .022), and peripheral arterial disease increased by 10 times (OR = 10.631; 95% CI = 2.969-57.029; P = .001). The LLA in individuals with DM in two specialized outpatient services was higher compared to international literature; DPN and PAD were confirmed as risk factors for amputation, according to literature. This finding suggests that the study population faces an increased risk of amputation, highlighting the urgent need for targeted interventions and implementing robust preventive strategies to transform the current scenario and mitigate these severe outcomes. A comprehensive approach is essential to proactively address the underlying issues and reduce the prevalence and impact of amputations in Brazil. Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Databáze: | MEDLINE |
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