Lower-extremity amputation increases mortality risk in diabetes

Adults with diabetes who undergo a lower extremity amputation are more likely to die at any given point than those who do not have an amputation, according to research in Diabetes Care.

Ole Hoffstad, MD
, of the Department of Biostatistics and Epidemiology at the University of Pennsylvania Perelman School of Medicine in Philadelphia, and colleagues analyzed hospital data from 416,434 patients with diabetes participating in The Health Improvement Network (THIN) between 2002 and 2012, each followed for an average of 9 years. During that time, 6,566 patients (1.6%) had a lower extremity amputation and 77,215 of those patients (18.5%) died. Within the cohort, 1% of those with a lower extremity amputation died within 30 days; 9.9% died within 1 year; 27.2% died within 5 years.

For the full cohort, the rate of death was 2% after 1 year of follow-up and 7.3% after 5 years of follow-up.

The hazard ratio for death following a lower extremity amputation was 3.02 (95% CI, 2.90-3.14); 2.37 (95% CI, 2.27-2.48) after adjusting for other risk factors, according to researchers.

“In general, those with a lower extremity amputation were more than three times more likely to die during a year of follow-up than an individual with diabetes who had not had an amputation.”

Researchers said patients who undergo a lower extremity amputation require more vigilant follow-up and evaluation to ensure optimal care.

“It is also important that [general practitioners] communicate to their patients about the risk of death to [ensure] that patients have proper expectations about the severity of their disease,” the researchers wrote. by Regina Schaffer

Disclosure: The researchers report no relevant financial disclosures.

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