We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Differences in minor amputation rate in diabetic foot disease throughout Europe are in part explained by differences in disease severity at presentation.
- Authors
van Battum, P.; Schaper, N.; Prompers, L.; Apelqvist, J.; Jude, E.; Piaggesi, A.; Bakker, K.; Edmonds, M.; Holstein, P.; Jirkovska, A.; Mauricio, D.; Ragnarson Tennvall, G.; Reike, H.; Spraul, M.; Uccioli, L.; Urbancic, V.; van Acker, K.; van Baal, J.; Ferreira, I.; Huijberts, M.
- Abstract
Objectives The incidence of minor amputation may vary significantly, and determinants of minor amputation have not been studied systematically. We evaluated minor amputation rate, the determinants of minor amputation and differences in amputation rate between European centres. Methods In the Eurodiale study, a prospective cohort study of 1232 patients (1088 followed until end-point) with a new diabetic foot ulcer were followed on a monthly basis until healing, death, major amputation or up to a maximum of 1 year. Ulcers were treated according to international guidelines. Baseline characteristics independently associated with minor amputation were examined using multiple logistic regression modelling. Based on the results of the multi variable analysis, a disease severity score was calculated for each patient. Results One hundred and ninety-four (18%) patients underwent a minor amputation. Predictors of minor amputation were depth of the ulcer (odds ratio 6.08, confidence interval 4.10-9.03), peripheral arterial disease (odds ratio 1.84, confidence interval 1.30-2.60), infection (odds ratio 1.56, confidence interval 1.05-2.30) and male sex (odds ratio 1.42, confidence interval 0.99-2.04). Minor amputation rate varied between 2.4 and 34% in the centres. Minor amputation rate in centres correlated strongly with disease severity score at the moment of presentation to the foot clinic (r = 0.75). Conclusions Minor amputation is performed frequently in diabetic foot centres throughout Europe and is determined by depth of the ulcer, peripheral arterial disease, infection and male sex. There are important differences in amputation rate between the European centres, which can be explained in part by severity of disease at presentation. This may suggest that early referral to foot clinics can prevent minor amputations.
- Subjects
EUROPE; DIABETIC foot; COMPUTER software; CONFIDENCE intervals; EPIDEMIOLOGY; LEG amputation; LONGITUDINAL method; MEDICAL care use; MEDICAL cooperation; MULTIVARIATE analysis; PERIPHERAL vascular diseases; RESEARCH; SEX distribution; DATA analysis; MULTIPLE regression analysis; SEVERITY of illness index; EARLY medical intervention; SURGERY
- Publication
Diabetic Medicine, 2011, Vol 28, Issue 2, p199
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/j.1464-5491.2010.03192.x