Ü Gök1, Ö Selek2, A Selek3, A Güdük4, M Ç Güner5. 1. Department of Orthopaedics and Traumatology, İzmit SEKA State Hospital, 41100, Kocaeli, Turkey. drumitgok@hotmail.com. 2. Department of Orthopaedics and Traumatology, School of Medicine, Kocaeli University, Kocaeli, Turkey. 3. Department of Endocrinology and Metabolism, School of Medicine, Kocaeli University, Kocaeli, Turkey. 4. Department of Orthopaedics and Traumatology, Rize State Hospital, Rize, Turkey. 5. Department of Podiatry, School of Medicine, Acıbadem University, Istanbul, Turkey.
Abstract
PURPOSE: The purpose of this study was to evaluate the survival after major lower-limb amputation, at a level either below (BKA) or above (AKA) the knee, in diabetic patients. METHODS: A total of 140 diabetic patients who underwent major lower-limb amputation during the period of 2001-2011 were enrolled in the study. The patients were grouped as below-knee and above-knee amputations. The differences in survival by age, gender, amputation level and revision surgery were investigated. The clinical follow-up periods and the results of the patients with major lower-limb amputation were retrospectively assessed. RESULTS: The mean follow-up period was 24.87 months (range 0.06-120 months). The mortality rate of series was 32.8 % for 1 year and 70 % for 5 years. One-year mortality rate was 24.6 % and 5-year mortality rate was 66.3 % in below-knee group, 1-year mortality rate was 43.3 % and 5-year mortality rate was 83.3 % in above-knee group. The difference between mortality rates of these groups was significant (p: 0.019). There was no statistically significant difference according to age and gender (p: 0.543 and 0.568). The previous minor amputations were found to have no effect on mortality (p: 0.471). CONCLUSION: Routine utilization of diabetes follow-up, screening and treatment programs with a multidisciplinary approach might be mandatory to handle early multisystem involvement-prevent major amputation, and increase survival rate in diabetic patients. LEVEL OF EVIDENCE: Retrospective cohort study, Level III.
PURPOSE: The purpose of this study was to evaluate the survival after major lower-limb amputation, at a level either below (BKA) or above (AKA) the knee, in diabeticpatients. METHODS: A total of 140 diabeticpatients who underwent major lower-limb amputation during the period of 2001-2011 were enrolled in the study. The patients were grouped as below-knee and above-knee amputations. The differences in survival by age, gender, amputation level and revision surgery were investigated. The clinical follow-up periods and the results of the patients with major lower-limb amputation were retrospectively assessed. RESULTS: The mean follow-up period was 24.87 months (range 0.06-120 months). The mortality rate of series was 32.8 % for 1 year and 70 % for 5 years. One-year mortality rate was 24.6 % and 5-year mortality rate was 66.3 % in below-knee group, 1-year mortality rate was 43.3 % and 5-year mortality rate was 83.3 % in above-knee group. The difference between mortality rates of these groups was significant (p: 0.019). There was no statistically significant difference according to age and gender (p: 0.543 and 0.568). The previous minor amputations were found to have no effect on mortality (p: 0.471). CONCLUSION: Routine utilization of diabetes follow-up, screening and treatment programs with a multidisciplinary approach might be mandatory to handle early multisystem involvement-prevent major amputation, and increase survival rate in diabeticpatients. LEVEL OF EVIDENCE: Retrospective cohort study, Level III.
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