scholarly journals Incidence of Lower-Limb Amputation in the Diabetic and Nondiabetic General Population: A 10-year population-based cohort study of initial unilateral and contralateral amputations and reamputations

Diabetes Care ◽  
2008 ◽  
Vol 32 (2) ◽  
pp. 275-280 ◽  
Author(s):  
A. Johannesson ◽  
G.-U. Larsson ◽  
N. Ramstrand ◽  
A. Turkiewicz ◽  
A.-B. Wirehn ◽  
...  
Keyword(s):  
Cohort Study ◽  
General Population ◽  
Lower Limb ◽  
Population Based ◽  
Lower Limb Amputation ◽  
Limb Amputation

scholarly journals Associations between attainment of incentivized primary care indicators and incident lower limb amputation among those with type 2 diabetes: a population-based historical cohort study

2021 ◽  
Vol 9 (1) ◽  
pp. e002069
Author(s):  
Laura H Gunn ◽  
Eszter P Vamos ◽  
Azeem Majeed ◽  
Pasha Normahani ◽  
Usman Jaffer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Cohort Study ◽  
Lower Limb ◽  
Population Based ◽  
Lower Limb Amputation ◽  
Medical Decision ◽  
Limb Amputation

IntroductionEngland has invested considerably in diabetes care through such programs as the Quality and Outcomes Framework (QOF) and National Diabetes Audit (NDA). Associations between program indicators and clinical endpoints, such as amputation, remain unclear. We examined associations between primary care indicators and incident lower limb amputation.Research design and methodsThis population-based retrospective cohort study, spanning 2010–2017, was comprised of adults in England with type 2 diabetes and no history of lower limb amputation. Exposures at baseline (2010–2011) were attainment of QOF glycated hemoglobin (HbA1c), blood pressure and total cholesterol indicators, and number of NDA processes completed. Propensity score matching was performed and multivariable Cox proportional hazards models, adjusting for disease-related, comorbidity, lifestyle, and sociodemographic factors, were fitted using matched samples for each exposure.Results83 688 individuals from 330 English primary care practices were included. Mean follow-up was 3.9 (SD 2.0) years, and 521 (0.6%) minor or major amputations were observed (1.62 per 1000 person-years). HbA1c and cholesterol indicator attainment were associated with considerably lower risks of minor or major amputation (adjusted HRs; 95% CIs) 0.61 (0.49 to 0.74; p<0.0001) and 0.67 (0.53 to 0.86; p=0.0017), respectively). No evidence of association between blood pressure indicator attainment and amputation was observed (adjusted HR 0.88 (0.73 to 1.06; p=0.1891)). Substantially lower amputation rates were observed among those completing a greater number of NDA care processes (adjusted HRs 0.45 (0.24 to 0.83; p=0.0106), 0.67 (0.47 to 0.97; p=0.0319), and 0.38 (0.20 to 0.70; p=0.0022) for comparisons of 4–6 vs 0–3, 7–9 vs 0–3, and 7–9 vs 4–6 processes, respectively). Results for major-only amputations were similar for HbA1c and blood pressure, though cholesterol indicator attainment was non-significant.ConclusionsComprehensive primary care-based secondary prevention may offer considerable protection against diabetes-related amputation. This has important implications for diabetes management and medical decision-making for patients, as well as type 2 diabetes quality improvement programs.

scholarly journals Foot Ulcer and Risk of Lower Limb Amputation or Death in People With Diabetes: A National Population-Based Retrospective Cohort Study

Diabetes Care ◽  
2021 ◽  
pp. dc211596
Author(s):  
Rosemary C. Chamberlain ◽  
Kelly Fleetwood ◽  
Sarah H. Wild ◽  
Helen M. Colhoun ◽  
Robert S. Lindsay ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Lower Limb ◽  
Retrospective Cohort ◽  
Foot Ulcer ◽  
Population Based ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
National Population

scholarly journals Skin problems of the stump and hand function in lower limb amputees: A historic cohort study

2008 ◽  
Vol 32 (2) ◽  
pp. 179-185 ◽  
Author(s):  
E. C. T. Baars ◽  
P. U. Dijkstra ◽  
J. H. B. Geertzen
Keyword(s):  
Cohort Study ◽  
Lower Limb ◽  
Hand Function ◽  
Study Data ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Amputation Stump ◽  
Increased Risk ◽  
Co Morbidity ◽  
Historic Cohort

The aim of this study was to investigate the relationship between liner-related skin problems of the stump in patients with a lower limb amputation and impaired hand function. Sixty patients who were treated in a rehabilitation hospital from 1998–2006 were included in an historic cohort study. Data were collected concerning the amputation, skin problems of the stump, co-morbidity, hand function, the prosthesis, liner use and mobility score. The study population consisted of 50 trans-tibial and 10 knee disarticulation amputees, 43 male and 17 female, with a mean age of 62.3 years. The majority (63%) had a vascular reason for amputation. Blisters, folliculitis, rash and surface wounds on the stump were operationalized as being liner related. In patients with an impaired hand function, 70% had experienced liner-related skin problems of the stump, whereas 32% of the patients with a normal hand function had experienced skin problems ( p = 0.035). This study shows that impaired hand function poses an increased risk for skin problems in the amputation stump in patients with a lower limb amputation and liner use in their prosthesis.

scholarly journals Incidence of lower limb amputation in people with and without diabetes: a nationwide 5-year cohort study in Japan

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048436
Author(s):  
Fumika Kamitani ◽  
Yuichi Nishioka ◽  
Tatsuya Noda ◽  
Tomoya Myojin ◽  
Shinichiro Kubo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lower Limb ◽  
Time Trend ◽  
Major Amputation ◽  
Significant Decline ◽  
Lower Limb Amputation ◽  
Amputation Rate ◽  
Limb Amputation ◽  
National Healthcare ◽  
Minor Amputation

IntroductionThis study was conducted to investigate the incidence and time trend of lower limb amputation (LLA) among people with and without diabetes.Research design and methodsThis retrospective population-based cohort study was based on the national claims data in Japan, comprising a total population of 150 million. Data of all individuals who had LLA from April 2013 to March 2018 were obtained. We analysed the sex-adjusted and age-adjusted annual LLA rate (every fiscal year) in people with and without diabetes for major and minor amputation. To test for time trend, Poisson regression models were fitted.ResultsIn the 5-year period, 30 187 major and 29 299 minor LLAs were performed in Japan. The sex-adjusted and age-adjusted incidence of major and minor LLAs was 9.5 (people with diabetes, 21.8 vs people without diabetes, 2.3, per 100 000 person-years) and 14.9 (people with diabetes, 28.4 vs people without diabetes, 1.9, per 100 000 person-years) times higher, respectively, in people with diabetes compared with those without. A significant decline in the annual major amputation rate was observed (p<0.05) and the annual minor amputation rate remained stable (p=0.63) when sex, age and people with and without diabetes were included as dependent variables.ConclusionsThis is the first report of the national statistics of LLAs in Japan. The incidence of major and minor LLAs was 10 and 15 times higher, respectively, in people with diabetes compared with those without. A significant decline in the major amputation rate was observed, and the annual minor amputation rate remained stable during the observation period. This information can help to create an effective national healthcare strategy for preventing limb amputations, which affect the quality of life of patients with diabetes and add to the national healthcare expenditure.

Common Mental Disorders in Patients Undergoing Lower Limb Amputation: A Population-based Sample

2012 ◽  
Vol 36 (5) ◽  
pp. 1011-1015 ◽  
Author(s):  
Marco Antonio Nunes ◽  
Newton de Barros ◽  
Fausto Miranda ◽  
José Carlos Baptista-Silva
Keyword(s):  
Mental Disorders ◽  
Lower Limb ◽  
Common Mental Disorders ◽  
Population Based ◽  
Lower Limb Amputation ◽  
Limb Amputation

Ethnicity and risk of lower limb amputation in people with Type 2 diabetes: a prospective cohort study

2015 ◽  
Vol 33 (1) ◽  
pp. 55-61 ◽  
Author(s):  
T. E. Robinson ◽  
T. Kenealy ◽  
M. Garrett ◽  
D. Bramley ◽  
P. L. Drury ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Lower Limb ◽  
Prospective Cohort ◽  
Lower Limb Amputation ◽  
Limb Amputation
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