Timing of minor and major amputation in patients with diabetes‐related foot ulceration admitted to two public tertiary referral hospitals in Australia
Background There is limited information regarding the number of patients with diabetes‐related foot ulceration (DFU) who receive minor or major amputation, and how quickly these amputations occur. This study aimed to identify the incidence of index minor and major amputation among inpatients with DF...
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| Veröffentlicht in: | ANZ journal of surgery 2023-06, Vol.93 (6), p.1510-1516 |
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| container_title | ANZ journal of surgery |
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| creator | Manewell, Sarah M. Aitken, Sarah J. Nube, Vanessa L. Crawford, Anna M. Constantino, Maria I. Twigg, Stephen M. Menz, Hylton B. Sherrington, Catherine Paul, Serene S. |
| description | Background
There is limited information regarding the number of patients with diabetes‐related foot ulceration (DFU) who receive minor or major amputation, and how quickly these amputations occur. This study aimed to identify the incidence of index minor and major amputation among inpatients with DFU over 4 years, and where amputation occurred during the patient's index DFU‐related admission, investigate prognostic factors.
Methods
The incidence of index minor and major amputation, and the admission sequence during which amputation occurred were identified from DFU‐related admissions to two public hospitals during 2014–2018. Where minor or major amputation occurred during the patient's index DFU‐related admission, prognostic factors were investigated using logistic regression.
Results
DFU‐related hospital admissions were required by 564 patients. The incidence of minor amputation over 4 years was 34% (n = 193). The incidence of minor amputation during the patient's index DFU‐related admission was 28% (n = 155), which was associated with requiring revascularisation (odds ratio [OR] 2.33, 95% CI 1.53–3.55, P |
| doi_str_mv | 10.1111/ans.18224 |
| format | Article |
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There is limited information regarding the number of patients with diabetes‐related foot ulceration (DFU) who receive minor or major amputation, and how quickly these amputations occur. This study aimed to identify the incidence of index minor and major amputation among inpatients with DFU over 4 years, and where amputation occurred during the patient's index DFU‐related admission, investigate prognostic factors.
Methods
The incidence of index minor and major amputation, and the admission sequence during which amputation occurred were identified from DFU‐related admissions to two public hospitals during 2014–2018. Where minor or major amputation occurred during the patient's index DFU‐related admission, prognostic factors were investigated using logistic regression.
Results
DFU‐related hospital admissions were required by 564 patients. The incidence of minor amputation over 4 years was 34% (n = 193). The incidence of minor amputation during the patient's index DFU‐related admission was 28% (n = 155), which was associated with requiring revascularisation (odds ratio [OR] 2.33, 95% CI 1.53–3.55, P < 0.001). The incidence of major amputation over 4 years was 8% (n = 45). The incidence of major amputation during the patient's index DFU‐related admission was 6% (n = 31), which was associated with having more comorbidities (OR 1.58, 95% CI 1.10–2.26, P = 0.01) and receiving care for a mental health condition (OR 3.85, 95% CI 1.48–10.01, P = 0.006).
Conclusion
Most amputations occurred during the patient's index DFU‐related hospital admission. Major amputation during a patient's index admission was associated with more comorbidities and mental health conditions.
For inpatients with diabetes‐related foot ulceration (DFU) the incidence of minor amputation was 34% and major amputation was 8% over four years. Most amputations occurred during the patient's index DFU‐related hospital admission. Minor amputation during the patient's index DFU‐related admission was associated with requiring revascularisation, while major amputation during the patient's index DFU‐related admission was associated with having more comorbidities and receiving care for a mental health condition. Minor or major amputation according to DFU‐related hospital admission sequence</description><identifier>ISSN: 1445-1433</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1111/ans.18224</identifier><identifier>PMID: 36576076</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Amputation ; Comorbidity ; Diabetes ; Diabetes mellitus ; diabetic foot ; foot ulcer ; hospitalization ; Hospitals ; Mental disorders ; Mental health ; Patients</subject><ispartof>ANZ journal of surgery, 2023-06, Vol.93 (6), p.1510-1516</ispartof><rights>2022 The Authors. published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.</rights><rights>2022 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3884-2ed74147a1ef33cc0781e3b118af8e8952479945b804996ae532277b4c2caf6c3</citedby><cites>FETCH-LOGICAL-c3884-2ed74147a1ef33cc0781e3b118af8e8952479945b804996ae532277b4c2caf6c3</cites><orcidid>0000-0002-6701-6213 ; 0000-0002-3593-1396 ; 0000-0003-0013-9507</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fans.18224$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fans.18224$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36576076$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Manewell, Sarah M.</creatorcontrib><creatorcontrib>Aitken, Sarah J.</creatorcontrib><creatorcontrib>Nube, Vanessa L.</creatorcontrib><creatorcontrib>Crawford, Anna M.</creatorcontrib><creatorcontrib>Constantino, Maria I.</creatorcontrib><creatorcontrib>Twigg, Stephen M.</creatorcontrib><creatorcontrib>Menz, Hylton B.</creatorcontrib><creatorcontrib>Sherrington, Catherine</creatorcontrib><creatorcontrib>Paul, Serene S.</creatorcontrib><title>Timing of minor and major amputation in patients with diabetes‐related foot ulceration admitted to two public tertiary referral hospitals in Australia</title><title>ANZ journal of surgery</title><addtitle>ANZ J Surg</addtitle><description>Background
There is limited information regarding the number of patients with diabetes‐related foot ulceration (DFU) who receive minor or major amputation, and how quickly these amputations occur. This study aimed to identify the incidence of index minor and major amputation among inpatients with DFU over 4 years, and where amputation occurred during the patient's index DFU‐related admission, investigate prognostic factors.
Methods
The incidence of index minor and major amputation, and the admission sequence during which amputation occurred were identified from DFU‐related admissions to two public hospitals during 2014–2018. Where minor or major amputation occurred during the patient's index DFU‐related admission, prognostic factors were investigated using logistic regression.
Results
DFU‐related hospital admissions were required by 564 patients. The incidence of minor amputation over 4 years was 34% (n = 193). The incidence of minor amputation during the patient's index DFU‐related admission was 28% (n = 155), which was associated with requiring revascularisation (odds ratio [OR] 2.33, 95% CI 1.53–3.55, P < 0.001). The incidence of major amputation over 4 years was 8% (n = 45). The incidence of major amputation during the patient's index DFU‐related admission was 6% (n = 31), which was associated with having more comorbidities (OR 1.58, 95% CI 1.10–2.26, P = 0.01) and receiving care for a mental health condition (OR 3.85, 95% CI 1.48–10.01, P = 0.006).
Conclusion
Most amputations occurred during the patient's index DFU‐related hospital admission. Major amputation during a patient's index admission was associated with more comorbidities and mental health conditions.
For inpatients with diabetes‐related foot ulceration (DFU) the incidence of minor amputation was 34% and major amputation was 8% over four years. Most amputations occurred during the patient's index DFU‐related hospital admission. Minor amputation during the patient's index DFU‐related admission was associated with requiring revascularisation, while major amputation during the patient's index DFU‐related admission was associated with having more comorbidities and receiving care for a mental health condition. Minor or major amputation according to DFU‐related hospital admission sequence</description><subject>Amputation</subject><subject>Comorbidity</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>diabetic foot</subject><subject>foot ulcer</subject><subject>hospitalization</subject><subject>Hospitals</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Patients</subject><issn>1445-1433</issn><issn>1445-2197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp1kc1u1DAUhS1UREthwQsgS93QxbT-jZ3lqGoLUgULytpynBvqURKntqNRd30Eln0-ngRPM7BAqjf36Przub46CH2g5IyWc27HdEY1Y-IVOqJCyBWjtTrYayo4P0RvU9oQQquqlm_QIa-kqoiqjtDTrR_8-BOHDpcaIrZjiwe72alhmrPNPozYj3gqCsac8NbnO9x620CG9PvxV4TeZmhxF0LGc-8gLm9sO_i8u8gB523A09z03uEMMXsbH3CEDmK0Pb4LafLZ9mk3Zj2nXJrevkOvu9KD9_t6jH5cXd5efF7dfLv-crG-WTmutVgxaJWgQlkKHefOEaUp8IZSbTsNupZMqLoWstFE1HVlQXLGlGqEY852lePH6NPiO8VwP0PKZvDJQd_bEcKcDFOyJoQTJQt68h-6CXMcy-8M00wKUjKoCnW6UC6GlMqWZop-KBsbSswuLlPiMs9xFfbj3nFuBmj_kX_zKcD5Amx9Dw8vO5n11--L5R-n8KH_</recordid><startdate>202306</startdate><enddate>202306</enddate><creator>Manewell, Sarah M.</creator><creator>Aitken, Sarah J.</creator><creator>Nube, Vanessa L.</creator><creator>Crawford, Anna M.</creator><creator>Constantino, Maria I.</creator><creator>Twigg, Stephen M.</creator><creator>Menz, Hylton B.</creator><creator>Sherrington, Catherine</creator><creator>Paul, Serene S.</creator><general>John Wiley & Sons Australia, Ltd</general><general>Blackwell Publishing Ltd</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6701-6213</orcidid><orcidid>https://orcid.org/0000-0002-3593-1396</orcidid><orcidid>https://orcid.org/0000-0003-0013-9507</orcidid></search><sort><creationdate>202306</creationdate><title>Timing of minor and major amputation in patients with diabetes‐related foot ulceration admitted to two public tertiary referral hospitals in Australia</title><author>Manewell, Sarah M. ; Aitken, Sarah J. ; Nube, Vanessa L. ; Crawford, Anna M. ; Constantino, Maria I. ; Twigg, Stephen M. ; Menz, Hylton B. ; Sherrington, Catherine ; Paul, Serene S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3884-2ed74147a1ef33cc0781e3b118af8e8952479945b804996ae532277b4c2caf6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Amputation</topic><topic>Comorbidity</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>diabetic foot</topic><topic>foot ulcer</topic><topic>hospitalization</topic><topic>Hospitals</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Patients</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manewell, Sarah M.</creatorcontrib><creatorcontrib>Aitken, Sarah J.</creatorcontrib><creatorcontrib>Nube, Vanessa L.</creatorcontrib><creatorcontrib>Crawford, Anna M.</creatorcontrib><creatorcontrib>Constantino, Maria I.</creatorcontrib><creatorcontrib>Twigg, Stephen M.</creatorcontrib><creatorcontrib>Menz, Hylton B.</creatorcontrib><creatorcontrib>Sherrington, Catherine</creatorcontrib><creatorcontrib>Paul, Serene S.</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>ANZ journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Manewell, Sarah M.</au><au>Aitken, Sarah J.</au><au>Nube, Vanessa L.</au><au>Crawford, Anna M.</au><au>Constantino, Maria I.</au><au>Twigg, Stephen M.</au><au>Menz, Hylton B.</au><au>Sherrington, Catherine</au><au>Paul, Serene S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Timing of minor and major amputation in patients with diabetes‐related foot ulceration admitted to two public tertiary referral hospitals in Australia</atitle><jtitle>ANZ journal of surgery</jtitle><addtitle>ANZ J Surg</addtitle><date>2023-06</date><risdate>2023</risdate><volume>93</volume><issue>6</issue><spage>1510</spage><epage>1516</epage><pages>1510-1516</pages><issn>1445-1433</issn><eissn>1445-2197</eissn><abstract>Background
There is limited information regarding the number of patients with diabetes‐related foot ulceration (DFU) who receive minor or major amputation, and how quickly these amputations occur. This study aimed to identify the incidence of index minor and major amputation among inpatients with DFU over 4 years, and where amputation occurred during the patient's index DFU‐related admission, investigate prognostic factors.
Methods
The incidence of index minor and major amputation, and the admission sequence during which amputation occurred were identified from DFU‐related admissions to two public hospitals during 2014–2018. Where minor or major amputation occurred during the patient's index DFU‐related admission, prognostic factors were investigated using logistic regression.
Results
DFU‐related hospital admissions were required by 564 patients. The incidence of minor amputation over 4 years was 34% (n = 193). The incidence of minor amputation during the patient's index DFU‐related admission was 28% (n = 155), which was associated with requiring revascularisation (odds ratio [OR] 2.33, 95% CI 1.53–3.55, P < 0.001). The incidence of major amputation over 4 years was 8% (n = 45). The incidence of major amputation during the patient's index DFU‐related admission was 6% (n = 31), which was associated with having more comorbidities (OR 1.58, 95% CI 1.10–2.26, P = 0.01) and receiving care for a mental health condition (OR 3.85, 95% CI 1.48–10.01, P = 0.006).
Conclusion
Most amputations occurred during the patient's index DFU‐related hospital admission. Major amputation during a patient's index admission was associated with more comorbidities and mental health conditions.
For inpatients with diabetes‐related foot ulceration (DFU) the incidence of minor amputation was 34% and major amputation was 8% over four years. Most amputations occurred during the patient's index DFU‐related hospital admission. Minor amputation during the patient's index DFU‐related admission was associated with requiring revascularisation, while major amputation during the patient's index DFU‐related admission was associated with having more comorbidities and receiving care for a mental health condition. Minor or major amputation according to DFU‐related hospital admission sequence</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>36576076</pmid><doi>10.1111/ans.18224</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-6701-6213</orcidid><orcidid>https://orcid.org/0000-0002-3593-1396</orcidid><orcidid>https://orcid.org/0000-0003-0013-9507</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Access via Wiley Online Library |
| subjects | Amputation Comorbidity Diabetes Diabetes mellitus diabetic foot foot ulcer hospitalization Hospitals Mental disorders Mental health Patients |
| title | Timing of minor and major amputation in patients with diabetes‐related foot ulceration admitted to two public tertiary referral hospitals in Australia |
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