The impact of diabetes on mortality rates after lower extremity amputation

Objective To assess the impact of diabetes, amputation level, sex and age on mortality rates after lower extremity amputation (LEA) in Belgium, and to assess temporal trends in one‐year survival rates from 2009 to 2018. Methods Nationwide data on individuals who underwent minor and major LEA from 20...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Diabetic medicine 2024-01, Vol.41 (1), p.e15152-n/a
Hauptverfasser: Lauwers, Patrick, Wouters, Kristien, Vanoverloop, Johan, Avalosse, Hervé, Hendriks, Jeroen M. H., Nobels, Frank, Dirinck, Eveline, Dumont, Isabelle, Felix, Patricia, Matricali, Giovanni
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page n/a
container_issue 1
container_start_page e15152
container_title Diabetic medicine
container_volume 41
creator Lauwers, Patrick
Wouters, Kristien
Vanoverloop, Johan
Avalosse, Hervé
Hendriks, Jeroen M. H.
Nobels, Frank
Dirinck, Eveline
Dumont, Isabelle
Felix, Patricia
Matricali, Giovanni
description Objective To assess the impact of diabetes, amputation level, sex and age on mortality rates after lower extremity amputation (LEA) in Belgium, and to assess temporal trends in one‐year survival rates from 2009 to 2018. Methods Nationwide data on individuals who underwent minor and major LEA from 2009 to 2018 were collected. Kaplan–Meier survival curves were constructed. A Cox regression model with time‐varying coefficients was used to estimate the likelihood of mortality after LEA in individuals with or without diabetes. Matched amputation‐free individuals with or without diabetes were used for comparison. Time trends were analysed. Results Amputations 41,304 were performed: 13,247 major and 28,057 minor. Five‐year mortality rates in individuals with diabetes were 52% and 69% after minor and major LEA, respectively (individuals without diabetes: 45% and 63%, respectively). In the first six postoperative months, no differences in mortality rates were found between individuals with or without diabetes. Later, hazard ratios (HRs) for mortality in individuals with diabetes (compared with no diabetes) after minor LEA ranged from 1.38 to 1.52, and after major LEA from 1.35 to 1.46 (all p ≤ 0.005). Among individuals without LEA, HRs for mortality in diabetes (versus no diabetes) were systematically higher compared to the HRs for mortality in diabetes (versus no diabetes) after minor and major LEA. One‐year survival rates did not change for individuals with diabetes. Conclusions In the first six postoperative months, mortality rates after LEA were not different between individuals with or without diabetes; later, diabetes was significantly associated with increased mortality. However, as HRs for mortality were higher in amputation‐free individuals, diabetes impacts mortality less in the minor and major amputation groups relative to the comparison group of individuals without LEA.
doi_str_mv 10.1111/dme.15152
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2819276039</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2901356067</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3482-218a26a8bc651af37419d15c9cc987bdea63cac8fd9ccf1061c5f9dc72829f923</originalsourceid><addsrcrecordid>eNp1kE1LAzEQhoMotn4c_AOy4EUP22aS3c3mKLV-UfFSzyHNJrhlt6lJltp_b-pWD4IDMwPvPLwML0IXgEcQa1y1egQ55OQADSErsjTPOByiIWYZSSlmMEAn3i8xBsIpP0YDyghhsYfoef6uk7pdSxUSa5KqlgsdtE_sKmmtC7KpwzZxcidJE7RLGruJU38Gp9vdTbbrLshQ29UZOjKy8fp8v0_R2_10PnlMZ68PT5PbWapoVpKUQClJIcuFKnKQhrIMeAW54krxki0qLQuqpCpNFRUDuACVG14pRkrCDSf0FF33vmtnPzrtg2hrr3TTyJW2nRekBE5YgSmP6NUfdGk7t4rfCcIx0LzABYvUTU8pZ7132oi1q1vptgKw2AUsYsDiO-DIXu4du0Wrq1_yJ9EIjHtgUzd6-7-TuHuZ9pZfyL-ENg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2901356067</pqid></control><display><type>article</type><title>The impact of diabetes on mortality rates after lower extremity amputation</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Lauwers, Patrick ; Wouters, Kristien ; Vanoverloop, Johan ; Avalosse, Hervé ; Hendriks, Jeroen M. H. ; Nobels, Frank ; Dirinck, Eveline ; Dumont, Isabelle ; Felix, Patricia ; Matricali, Giovanni</creator><creatorcontrib>Lauwers, Patrick ; Wouters, Kristien ; Vanoverloop, Johan ; Avalosse, Hervé ; Hendriks, Jeroen M. H. ; Nobels, Frank ; Dirinck, Eveline ; Dumont, Isabelle ; Felix, Patricia ; Matricali, Giovanni ; Belgian Amputation Group ; the Belgian Amputation Group</creatorcontrib><description>Objective To assess the impact of diabetes, amputation level, sex and age on mortality rates after lower extremity amputation (LEA) in Belgium, and to assess temporal trends in one‐year survival rates from 2009 to 2018. Methods Nationwide data on individuals who underwent minor and major LEA from 2009 to 2018 were collected. Kaplan–Meier survival curves were constructed. A Cox regression model with time‐varying coefficients was used to estimate the likelihood of mortality after LEA in individuals with or without diabetes. Matched amputation‐free individuals with or without diabetes were used for comparison. Time trends were analysed. Results Amputations 41,304 were performed: 13,247 major and 28,057 minor. Five‐year mortality rates in individuals with diabetes were 52% and 69% after minor and major LEA, respectively (individuals without diabetes: 45% and 63%, respectively). In the first six postoperative months, no differences in mortality rates were found between individuals with or without diabetes. Later, hazard ratios (HRs) for mortality in individuals with diabetes (compared with no diabetes) after minor LEA ranged from 1.38 to 1.52, and after major LEA from 1.35 to 1.46 (all p ≤ 0.005). Among individuals without LEA, HRs for mortality in diabetes (versus no diabetes) were systematically higher compared to the HRs for mortality in diabetes (versus no diabetes) after minor and major LEA. One‐year survival rates did not change for individuals with diabetes. Conclusions In the first six postoperative months, mortality rates after LEA were not different between individuals with or without diabetes; later, diabetes was significantly associated with increased mortality. However, as HRs for mortality were higher in amputation‐free individuals, diabetes impacts mortality less in the minor and major amputation groups relative to the comparison group of individuals without LEA.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/dme.15152</identifier><identifier>PMID: 37227722</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Amputation ; Amputation, Surgical ; Belgium ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus - epidemiology ; Diabetic Foot - complications ; Diabetic Foot - surgery ; Humans ; Lower Extremity - surgery ; lower extremity amputation ; Mortality ; Proportional Hazards Models ; Risk Factors ; Survival ; Survival Rate ; Trends</subject><ispartof>Diabetic medicine, 2024-01, Vol.41 (1), p.e15152-n/a</ispartof><rights>2023 Diabetes UK.</rights><rights>Diabetic Medicine © 2024 Diabetes UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3482-218a26a8bc651af37419d15c9cc987bdea63cac8fd9ccf1061c5f9dc72829f923</cites><orcidid>0000-0002-7394-4614</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%2Fdme.15152$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdme.15152$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37227722$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lauwers, Patrick</creatorcontrib><creatorcontrib>Wouters, Kristien</creatorcontrib><creatorcontrib>Vanoverloop, Johan</creatorcontrib><creatorcontrib>Avalosse, Hervé</creatorcontrib><creatorcontrib>Hendriks, Jeroen M. H.</creatorcontrib><creatorcontrib>Nobels, Frank</creatorcontrib><creatorcontrib>Dirinck, Eveline</creatorcontrib><creatorcontrib>Dumont, Isabelle</creatorcontrib><creatorcontrib>Felix, Patricia</creatorcontrib><creatorcontrib>Matricali, Giovanni</creatorcontrib><creatorcontrib>Belgian Amputation Group</creatorcontrib><creatorcontrib>the Belgian Amputation Group</creatorcontrib><title>The impact of diabetes on mortality rates after lower extremity amputation</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>Objective To assess the impact of diabetes, amputation level, sex and age on mortality rates after lower extremity amputation (LEA) in Belgium, and to assess temporal trends in one‐year survival rates from 2009 to 2018. Methods Nationwide data on individuals who underwent minor and major LEA from 2009 to 2018 were collected. Kaplan–Meier survival curves were constructed. A Cox regression model with time‐varying coefficients was used to estimate the likelihood of mortality after LEA in individuals with or without diabetes. Matched amputation‐free individuals with or without diabetes were used for comparison. Time trends were analysed. Results Amputations 41,304 were performed: 13,247 major and 28,057 minor. Five‐year mortality rates in individuals with diabetes were 52% and 69% after minor and major LEA, respectively (individuals without diabetes: 45% and 63%, respectively). In the first six postoperative months, no differences in mortality rates were found between individuals with or without diabetes. Later, hazard ratios (HRs) for mortality in individuals with diabetes (compared with no diabetes) after minor LEA ranged from 1.38 to 1.52, and after major LEA from 1.35 to 1.46 (all p ≤ 0.005). Among individuals without LEA, HRs for mortality in diabetes (versus no diabetes) were systematically higher compared to the HRs for mortality in diabetes (versus no diabetes) after minor and major LEA. One‐year survival rates did not change for individuals with diabetes. Conclusions In the first six postoperative months, mortality rates after LEA were not different between individuals with or without diabetes; later, diabetes was significantly associated with increased mortality. However, as HRs for mortality were higher in amputation‐free individuals, diabetes impacts mortality less in the minor and major amputation groups relative to the comparison group of individuals without LEA.</description><subject>Amputation</subject><subject>Amputation, Surgical</subject><subject>Belgium</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Diabetic Foot - complications</subject><subject>Diabetic Foot - surgery</subject><subject>Humans</subject><subject>Lower Extremity - surgery</subject><subject>lower extremity amputation</subject><subject>Mortality</subject><subject>Proportional Hazards Models</subject><subject>Risk Factors</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Trends</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1LAzEQhoMotn4c_AOy4EUP22aS3c3mKLV-UfFSzyHNJrhlt6lJltp_b-pWD4IDMwPvPLwML0IXgEcQa1y1egQ55OQADSErsjTPOByiIWYZSSlmMEAn3i8xBsIpP0YDyghhsYfoef6uk7pdSxUSa5KqlgsdtE_sKmmtC7KpwzZxcidJE7RLGruJU38Gp9vdTbbrLshQ29UZOjKy8fp8v0_R2_10PnlMZ68PT5PbWapoVpKUQClJIcuFKnKQhrIMeAW54krxki0qLQuqpCpNFRUDuACVG14pRkrCDSf0FF33vmtnPzrtg2hrr3TTyJW2nRekBE5YgSmP6NUfdGk7t4rfCcIx0LzABYvUTU8pZ7132oi1q1vptgKw2AUsYsDiO-DIXu4du0Wrq1_yJ9EIjHtgUzd6-7-TuHuZ9pZfyL-ENg</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Lauwers, Patrick</creator><creator>Wouters, Kristien</creator><creator>Vanoverloop, Johan</creator><creator>Avalosse, Hervé</creator><creator>Hendriks, Jeroen M. H.</creator><creator>Nobels, Frank</creator><creator>Dirinck, Eveline</creator><creator>Dumont, Isabelle</creator><creator>Felix, Patricia</creator><creator>Matricali, Giovanni</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7394-4614</orcidid></search><sort><creationdate>202401</creationdate><title>The impact of diabetes on mortality rates after lower extremity amputation</title><author>Lauwers, Patrick ; Wouters, Kristien ; Vanoverloop, Johan ; Avalosse, Hervé ; Hendriks, Jeroen M. H. ; Nobels, Frank ; Dirinck, Eveline ; Dumont, Isabelle ; Felix, Patricia ; Matricali, Giovanni</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3482-218a26a8bc651af37419d15c9cc987bdea63cac8fd9ccf1061c5f9dc72829f923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Amputation</topic><topic>Amputation, Surgical</topic><topic>Belgium</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Diabetic Foot - complications</topic><topic>Diabetic Foot - surgery</topic><topic>Humans</topic><topic>Lower Extremity - surgery</topic><topic>lower extremity amputation</topic><topic>Mortality</topic><topic>Proportional Hazards Models</topic><topic>Risk Factors</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lauwers, Patrick</creatorcontrib><creatorcontrib>Wouters, Kristien</creatorcontrib><creatorcontrib>Vanoverloop, Johan</creatorcontrib><creatorcontrib>Avalosse, Hervé</creatorcontrib><creatorcontrib>Hendriks, Jeroen M. H.</creatorcontrib><creatorcontrib>Nobels, Frank</creatorcontrib><creatorcontrib>Dirinck, Eveline</creatorcontrib><creatorcontrib>Dumont, Isabelle</creatorcontrib><creatorcontrib>Felix, Patricia</creatorcontrib><creatorcontrib>Matricali, Giovanni</creatorcontrib><creatorcontrib>Belgian Amputation Group</creatorcontrib><creatorcontrib>the Belgian Amputation Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lauwers, Patrick</au><au>Wouters, Kristien</au><au>Vanoverloop, Johan</au><au>Avalosse, Hervé</au><au>Hendriks, Jeroen M. H.</au><au>Nobels, Frank</au><au>Dirinck, Eveline</au><au>Dumont, Isabelle</au><au>Felix, Patricia</au><au>Matricali, Giovanni</au><aucorp>Belgian Amputation Group</aucorp><aucorp>the Belgian Amputation Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of diabetes on mortality rates after lower extremity amputation</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2024-01</date><risdate>2024</risdate><volume>41</volume><issue>1</issue><spage>e15152</spage><epage>n/a</epage><pages>e15152-n/a</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><abstract>Objective To assess the impact of diabetes, amputation level, sex and age on mortality rates after lower extremity amputation (LEA) in Belgium, and to assess temporal trends in one‐year survival rates from 2009 to 2018. Methods Nationwide data on individuals who underwent minor and major LEA from 2009 to 2018 were collected. Kaplan–Meier survival curves were constructed. A Cox regression model with time‐varying coefficients was used to estimate the likelihood of mortality after LEA in individuals with or without diabetes. Matched amputation‐free individuals with or without diabetes were used for comparison. Time trends were analysed. Results Amputations 41,304 were performed: 13,247 major and 28,057 minor. Five‐year mortality rates in individuals with diabetes were 52% and 69% after minor and major LEA, respectively (individuals without diabetes: 45% and 63%, respectively). In the first six postoperative months, no differences in mortality rates were found between individuals with or without diabetes. Later, hazard ratios (HRs) for mortality in individuals with diabetes (compared with no diabetes) after minor LEA ranged from 1.38 to 1.52, and after major LEA from 1.35 to 1.46 (all p ≤ 0.005). Among individuals without LEA, HRs for mortality in diabetes (versus no diabetes) were systematically higher compared to the HRs for mortality in diabetes (versus no diabetes) after minor and major LEA. One‐year survival rates did not change for individuals with diabetes. Conclusions In the first six postoperative months, mortality rates after LEA were not different between individuals with or without diabetes; later, diabetes was significantly associated with increased mortality. However, as HRs for mortality were higher in amputation‐free individuals, diabetes impacts mortality less in the minor and major amputation groups relative to the comparison group of individuals without LEA.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37227722</pmid><doi>10.1111/dme.15152</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7394-4614</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0742-3071
ispartof Diabetic medicine, 2024-01, Vol.41 (1), p.e15152-n/a
issn 0742-3071
1464-5491
language eng
recordid cdi_proquest_miscellaneous_2819276039
source MEDLINE; Access via Wiley Online Library
subjects Amputation
Amputation, Surgical
Belgium
Diabetes
Diabetes mellitus
Diabetes Mellitus - epidemiology
Diabetic Foot - complications
Diabetic Foot - surgery
Humans
Lower Extremity - surgery
lower extremity amputation
Mortality
Proportional Hazards Models
Risk Factors
Survival
Survival Rate
Trends
title The impact of diabetes on mortality rates after lower extremity amputation
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T17%3A35%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20impact%20of%20diabetes%20on%20mortality%20rates%20after%20lower%20extremity%20amputation&rft.jtitle=Diabetic%20medicine&rft.au=Lauwers,%20Patrick&rft.aucorp=Belgian%20Amputation%20Group&rft.date=2024-01&rft.volume=41&rft.issue=1&rft.spage=e15152&rft.epage=n/a&rft.pages=e15152-n/a&rft.issn=0742-3071&rft.eissn=1464-5491&rft_id=info:doi/10.1111/dme.15152&rft_dat=%3Cproquest_cross%3E2901356067%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2901356067&rft_id=info:pmid/37227722&rfr_iscdi=true