Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Diabetes Care 29:2252-2256, 2006
DOI: 10.2337/dc06-0926
© 2006 by the American Diabetes Association
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Schofield, C. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Schofield, C. J.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Clinical Care/Education/Nutrition
Original Article

Mortality and Hospitalization in Patients After Amputation

A comparison between patients with and without diabetes

Christopher J. Schofield, MB, CHB1, Gillian Libby, MSC2, Geraldine M. Brennan, MB, BCH1, Ritchie R. MacAlpine, BSC3, Andrew D. Morris, MD4, Graham P. Leese, MD1 for the DARTS/MEMO Collaboration

1 Wards 1 and 2, Ninewells Hospital and Medical School, Dundee, U.K.
2 Medicines Monitoring Unit, Department of Clinical Pharmacology, University of Dundee, Dundee, U.K.
3 Clinical Technology Centre, Ninewells Hospital and Medical School, Dundee, U.K.
4 Division of Medicine and Therapeutics and Medicines Monitoring Unit, Ninewells Hospital and Medical School, Dundee, U.K.

Address correspondence and reprint requests to Christopher J. Schofield, MB, ChB, Wards 1 and 2, Ninewells Hospital and Medical School, Dundee, DD1 9SY, U.K. E-mail: cschofield{at}nhs.net

OBJECTIVE—We sought to compare the risk of mortality and hospitalization between patients with and without diabetes following incident lower-extremity amputation (LEA).

RESEARCH DESIGN AND METHODS—We performed a retrospective data-linkage review of all incident amputations between 1 January 1992 and 31 December 1995. Patients were categorized according to their diabetes status. Follow-up for mortality was until 1 January 2005 and until 31 March 1996 for hospitalization.

RESULTS—Of 390 major-incident LEAs performed during the study period, 119 (30.5%) were in patients with diabetes and 271 (69.5%) were in nondiabetic subjects. The median time to death was 27.2 months in patients with diabetes compared with 46.7 months for patients without (P = 0.01). Diabetic subjects had a 55% greater risk of death than those without diabetes. The risk of developing congestive cardiac failure with diabetes was 2.26 (95% CI 1.12–4.57) and of further amputation was 1.95 (1.14–3.33) times that of a patient without diabetes after incident LEA.

CONCLUSIONS—After LEA, patients with diabetes have an increased risk of death compared with nondiabetic patients. Efforts should be made to minimize these risks with aggressive treatment of cardiovascular risk factors and management of cardiac failure.

Abbreviations: CHN, community health number • DARTS, Diabetes Audit and Research in Tayside Scotland • LEA, lower-extremity amputation • MEMO, Medicines Monitoring Unit • OPCS4, Office for Population Censuses and Surveys • PVD, peripheral vascular disease • SMR1, Scottish Morbidity Record 1


Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum
Copyright © 2006 by the American Diabetes Association.