TY - JOUR
T1 - Mortality of first-time amputees in diabetics
T2 - A 10-year observation
AU - Izumi, Yuki
AU - Satterfield, Kathleen
AU - Lee, Shuko
AU - Harkless, Lawrence B.
AU - Lavery, Lawrence A.
PY - 2009/1
Y1 - 2009/1
N2 - 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.
AB - 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.
KW - Amputation
KW - Diabetic foot
KW - Mortality
UR - http://www.scopus.com/inward/record.url?scp=57949091010&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=57949091010&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2008.09.005
DO - 10.1016/j.diabres.2008.09.005
M3 - Article
C2 - 19097667
AN - SCOPUS:57949091010
SN - 0168-8227
VL - 83
SP - 126
EP - 131
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
IS - 1
ER -