Mortality in diabetic and nondiabetic patients after amputations
performed from 1996 to 2005 in a tertiary hospital population: a 3-year
follow-up study
Aims: Diabetes is the leading cause of lower-extremity amputations
worldwide. The objective of this study was to look at the survival after
first amputation between subjects with and without diabetes in a sample
of Greek Population. Method: We performed a retrospective study of all
nontrauma, nonneoplasm-related amputations performed in a tertiary
centre during the years 1996-2005 in diabetic (n=183) and nondiabetic
patients (n=75). Survival status was assessed from the first amputation
until December 31, 2005. Results: A total of 54.6% of amputees with
diabetes and 51.6% of those without diabetes died in a mean [95%
confidence interval (CI)] time of 4.3 (3.5-5.1) and 6.6 (4.6-8.6) years
after the first amputation, respectively (P=.65). Diabetic patients
underwent a second amputation (P=.003) and contralateral amputations
(P=.02) more often in comparison with nondiabetic subjects. Predictors
of all-cause mortality in the diabetic group, after adjustment for sex,
were age [hazard ratio (FIR) (95% CI), 1.04 (1.02-1,06); P<.001] and
the level of amputation (major vs. minor) [HR, 1.55 (1.00-2.40),
P=.05]. The respective values in the nondiabetic patients were HR of
1.06 (1.03-1.08; P<.001) and HR of 3.12 (1.27-7.64; P=.01). Median
length of hospital stay was comparable between the two groups.
Conclusion: Mortality rates after amputation were high in both patients
with and without diabetes. Older age and a higher level of amputation
were associated with poorer survival. Diabetic patients more often
underwent a second amputation to the same and the contralateral limb.
Additionally, mortality rates, length of hospital stay, and
perioperative mortality were not different between patients with and
without diabetes. (C) 2009 Elsevier Inc. All rights reserved
