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Diabetes Res Clin Pract. 2009 Jan;83(1):126-31. doi: 10.1016/j.diabres.2008.09.005. Epub 2008 Dec 20.

Mortality of first-time amputees in diabetics: a 10-year observation.

Author information

1
WHO Collaborating Centre for Diabetes, National Hospital Organization Kyoto Medical Center, Fukakusa, Kyoto 612-8555, Japan. dfootjapan@hotmail.co.jp

Abstract

AIMS:

We analyze mortality of first-time diabetic amputees by stratifying by level of amputation, differentiating short-term and long-term mortality.

METHODS:

We evaluated 277 diabetic patients who received their first lower extremity amputation (LEA) during 1993-97. Subjects were followed until December 2003, and categorized by level of amputation. We compared the mortality difference by level for 0-10 years, 0-10 months, and 10 months-10 years, and examined the association of comorbid conditions and death for each level.

RESULTS:

We found a significant difference in mortality by amputation level for 0-10 years (p<0.05) and <10 months (p<0.01) survival, but not for the one of 10 months-10 years. For major amputees deceased within 10 months, sepsis was as frequent a cause of death as cardiovascular disease. In distal amputees, CVD, CAD and ESRD were strongly associated with death, but only CAD was associated death among major amputees.

CONCLUSION:

For diabetic patients undergoing first LEAs, the mortality of major amputees was worse than that of minor amputees due to the difference in first 10-month mortality. The history of comorbid conditions in first-time major amputees was less important than in minor amputees since sepsis was the frequent cause of death in major amputees in this early period.

PMID:
19097667
DOI:
10.1016/j.diabres.2008.09.005
[Indexed for MEDLINE]

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