Faisal Aziz1, Berthold Reichardt2, Caren Sourij3, Hans-Peter Dimai4, Daniela Reichart2, Gerd Köhler4, Marianne Brodmann5, Harald Sourij6. 1. Division of Endocrinology and Diabetology, Department of Medicine, Medical University of Graz, Graz, Austria; Center for Biomarker Research in Medicine, CBmed, Graz, Austria. 2. Austrian Health Insurance Fund, Austria. 3. Division of Cardiology, Department of Medicine, Medical University of Graz, Graz, Austria. 4. Division of Endocrinology and Diabetology, Department of Medicine, Medical University of Graz, Graz, Austria. 5. Division of Angiology, Department of Medicine, Medical University of Graz, Graz, Austria. 6. Division of Endocrinology and Diabetology, Department of Medicine, Medical University of Graz, Graz, Austria. Electronic address: ha.sourij@medunigraz.at.
Abstract
AIMS: To describe the incidence, mortality, and trend of major lower extremity amputations (LEA) and to assess risk factors of all-cause mortality after major LEA in individuals with diabetes. METHODS: Procedure codes of major LEA were extracted from the Austrian Health Insurance database (N = 507,180) during 2014-2017 to estimate crude and age-standardized rates per 100,000 population. Short- (30-day, 90-day) and long-term (1-year, 5-year) all-cause mortality after major LEA was estimated from the date of amputation till the date of death. RESULTS: The age-standardized rate of major LEA was 6.44 with an insignificant annual change of 3% (p = 0.825) from 2014 to 2017. Cumulative 30-day mortality was 13.5%, 90-day 22.0%, 1-year 34.4%, and 5-year 66.7%. Age, male sex, above-knee amputation, Charlson index, and heart failure were significantly associated with both short- and long-term mortality. Cancer, dementia, heart failure, peripheral vascular disease, and renal disease were associated with long-term mortality. CONCLUSIONS: The rate of major LEA in individuals with diabetes remained stable during 2014-2017 in Austria. Short- and long-term mortality rates were considerably high after major LEA. Old age, male sex, above-knee amputations, and Charlson Index were significant predictors of both short- and long-term mortality and comorbidities were significant predictors of long-term mortality only.
AIMS: To describe the incidence, mortality, and trend of major lower extremity amputations (LEA) and to assess risk factors of all-cause mortality after major LEA in individuals with diabetes. METHODS: Procedure codes of major LEA were extracted from the Austrian Health Insurance database (N = 507,180) during 2014-2017 to estimate crude and age-standardized rates per 100,000 population. Short- (30-day, 90-day) and long-term (1-year, 5-year) all-cause mortality after major LEA was estimated from the date of amputation till the date of death. RESULTS: The age-standardized rate of major LEA was 6.44 with an insignificant annual change of 3% (p = 0.825) from 2014 to 2017. Cumulative 30-day mortality was 13.5%, 90-day 22.0%, 1-year 34.4%, and 5-year 66.7%. Age, male sex, above-knee amputation, Charlson index, and heart failure were significantly associated with both short- and long-term mortality. Cancer, dementia, heart failure, peripheral vascular disease, and renal disease were associated with long-term mortality. CONCLUSIONS: The rate of major LEA in individuals with diabetes remained stable during 2014-2017 in Austria. Short- and long-term mortality rates were considerably high after major LEA. Old age, male sex, above-knee amputations, and Charlson Index were significant predictors of both short- and long-term mortality and comorbidities were significant predictors of long-term mortality only.
Authors: Magdalena Walicka; Marta Raczyńska; Karolina Marcinkowska; Iga Lisicka; Arthur Czaicki; Waldemar Wierzba; Edward Franek Journal: J Diabetes Res Date: 2021-07-24 Impact factor: 4.011