AIMS: We analyze mortality of first-time diabetic amputees by stratifying by level of amputation, differentiating short-term and long-term mortality. METHODS: We evaluated 277 diabetic patients who received their first lower extremity amputation (LEA) during 1993-97. Subjects were followed until December 2003, and categorized by level of amputation. We compared the mortality difference by level for 0-10 years, 0-10 months, and 10 months-10 years, and examined the association of comorbid conditions and death for each level. RESULTS: We found a significant difference in mortality by amputation level for 0-10 years (p<0.05) and <10 months (p<0.01) survival, but not for the one of 10 months-10 years. For major amputees deceased within 10 months, sepsis was as frequent a cause of death as cardiovascular disease. In distal amputees, CVD, CAD and ESRD were strongly associated with death, but only CAD was associated death among major amputees. CONCLUSION: For diabetic patients undergoing first LEAs, the mortality of major amputees was worse than that of minor amputees due to the difference in first 10-month mortality. The history of comorbid conditions in first-time major amputees was less important than in minor amputees since sepsis was the frequent cause of death in major amputees in this early period.
AIMS: We analyze mortality of first-time diabetic amputees by stratifying by level of amputation, differentiating short-term and long-term mortality. METHODS: We evaluated 277 diabeticpatients who received their first lower extremity amputation (LEA) during 1993-97. Subjects were followed until December 2003, and categorized by level of amputation. We compared the mortality difference by level for 0-10 years, 0-10 months, and 10 months-10 years, and examined the association of comorbid conditions and death for each level. RESULTS: We found a significant difference in mortality by amputation level for 0-10 years (p<0.05) and <10 months (p<0.01) survival, but not for the one of 10 months-10 years. For major amputees deceased within 10 months, sepsis was as frequent a cause of death as cardiovascular disease. In distal amputees, CVD, CAD and ESRD were strongly associated with death, but only CAD was associated death among major amputees. CONCLUSION: For diabeticpatients undergoing first LEAs, the mortality of major amputees was worse than that of minor amputees due to the difference in first 10-month mortality. The history of comorbid conditions in first-time major amputees was less important than in minor amputees since sepsis was the frequent cause of death in major amputees in this early period.
Authors: Andrew S Kimball; Amrita Joshi; William F Carson; Anna E Boniakowski; Matthew Schaller; Ronald Allen; Jennifer Bermick; Frank M Davis; Peter K Henke; Charles F Burant; Steve L Kunkel; Katherine A Gallagher Journal: Diabetes Date: 2017-06-29 Impact factor: 9.461
Authors: Andrew S Kimball; Frank M Davis; Aaron denDekker; Amrita D Joshi; Matthew A Schaller; Jennifer Bermick; Xianying Xing; Charles F Burant; Andrea T Obi; Dylan Nysz; Scott Robinson; Ron Allen; Nicholas W Lukacs; Peter K Henke; Johann E Gudjonsson; Bethany B Moore; Steve L Kunkel; Katherine A Gallagher Journal: Immunity Date: 2019-07-23 Impact factor: 31.745