Bernard Pac Soo1, Satyan Rajbhandari1, Ansy Egun2, Ushank Ranasinghe1, Ian M Lahart3, Joseph M Pappachan4. 1. Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire, UK. 2. Department of Vascular Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire, PR2 9HT, UK. 3. Faculty of Education, Health and Wellbeing, University of Wolverhampton, Walsall, UK. 4. Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire, UK. drpappachan@yahoo.co.in.
Abstract
BACKGROUND: Amputations are associated with markedly reduced long-term survival in patients with diabetic foot disease. However, there is paucity of long-term survival data in published literature. METHODS: We searched the electronic case records and laboratory details of patients who underwent amputations between 1997 and 2006 to obtain at least 10 years of follow up data after the surgery to assess the survival rates and possible risk factors reducing survival in the year 2016. Amputation level below ankle was considered as minor and above ankle as major amputations. RESULTS: Of the 233 cases (159 males; median age 68 years), 161 had major amputations. Of the 72 cases who had minor amputations initially, 63 needed a further amputation or contralateral amputation on follow up. One hundred seventy-seven patients (76%) were not alive after 10 years of follow up. The survival rates at 1, 3, 5, 7, and ≥10 years were 64%, 50%, 40%, 34%, and 24%, respectively. Maximum number of deaths occurred within 4 months of amputations. There was no difference between survival rates following major or minor amputations and among males or females. The only statistically significant parameter affecting lower survival rate was age ≥70 years, with each additional year of age increasing the hazard by a factor of 1.039 (95% CI: 1.024-1.054) or 3.9% (2.4-5.4%). CONCLUSIONS: Five-year and 10-year survival rates were 40% and 24%, respectively, following diabetic foot amputations. Higher age ≥70 years was associated with lower survival rate compared with younger age groups after lower extremity amputations.
BACKGROUND: Amputations are associated with markedly reduced long-term survival in patients with diabetic foot disease. However, there is paucity of long-term survival data in published literature. METHODS: We searched the electronic case records and laboratory details of patients who underwent amputations between 1997 and 2006 to obtain at least 10 years of follow up data after the surgery to assess the survival rates and possible risk factors reducing survival in the year 2016. Amputation level below ankle was considered as minor and above ankle as major amputations. RESULTS: Of the 233 cases (159 males; median age 68 years), 161 had major amputations. Of the 72 cases who had minor amputations initially, 63 needed a further amputation or contralateral amputation on follow up. One hundred seventy-seven patients (76%) were not alive after 10 years of follow up. The survival rates at 1, 3, 5, 7, and ≥10 years were 64%, 50%, 40%, 34%, and 24%, respectively. Maximum number of deaths occurred within 4 months of amputations. There was no difference between survival rates following major or minor amputations and among males or females. The only statistically significant parameter affecting lower survival rate was age ≥70 years, with each additional year of age increasing the hazard by a factor of 1.039 (95% CI: 1.024-1.054) or 3.9% (2.4-5.4%). CONCLUSIONS: Five-year and 10-year survival rates were 40% and 24%, respectively, following diabetic foot amputations. Higher age ≥70 years was associated with lower survival rate compared with younger age groups after lower extremity amputations.
Authors: Bill Cassidy; Neil D Reeves; Joseph M Pappachan; David Gillespie; Claire O'Shea; Satyan Rajbhandari; Arun G Maiya; Eibe Frank; Andrew Jm Boulton; David G Armstrong; Bijan Najafi; Justina Wu; Rupinder Singh Kochhar; Moi Hoon Yap Journal: touchREV Endocrinol Date: 2021-04-28
Authors: Andrew P Sawaya; Rivka C Stone; Spencer Mehdizadeh; Irena Pastar; Stephen Worrell; Nathan C Balukoff; Mariana J Kaplan; Marjana Tomic-Canic; Maria I Morasso Journal: EMBO Rep Date: 2022-07-20 Impact factor: 9.071