scholarly journals Location, Location, Location: Geographic Clustering of Lower-Extremity Amputation Among Medicare Beneficiaries With Diabetes

Diabetes Care ◽  
2011 ◽  
Vol 34 (11) ◽  
pp. 2363-2367 ◽  
Author(s):  
David J. Margolis ◽  
Ole Hoffstad ◽  
Jeffrey Nafash ◽  
Charles E. Leonard ◽  
Cristin P. Freeman ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Lower Extremity Amputation ◽  
Medicare Beneficiaries ◽  
Geographic Clustering ◽  
Extremity Amputation

scholarly journals Lower Extremity Amputation and Health Care Utilization in the Last Year of Life among Medicare Beneficiaries with ESRD

2019 ◽  
Vol 30 (3) ◽  
pp. 481-491 ◽  
Author(s):  
Catherine R. Butler ◽  
Margaret L. Schwarze ◽  
Ronit Katz ◽  
Susan M. Hailpern ◽  
William Kreuter ◽  
...  
Keyword(s):  
Health Care ◽  
Lower Extremity ◽  
End Of Life ◽  
End Of Life Care ◽  
Lower Extremity Amputation ◽  
Care Utilization ◽  
Life Care ◽  
Medicare Beneficiaries ◽  
Care Needs ◽  
Extremity Amputation

BackgroundLower extremity amputation is common among patients with ESRD, and often portends a poor prognosis. However, little is known about end-of-life care among patients with ESRD who undergo amputation.MethodsWe conducted a mortality follow-back study of Medicare beneficiaries with ESRD who died in 2002 through 2014 to analyze patterns of lower extremity amputation in the last year of life compared with a parallel cohort of beneficiaries without ESRD. We also examined the relationship between amputation and end-of-life care among the patients with ESRD.ResultsOverall, 8% of 754,777 beneficiaries with ESRD underwent at least one lower extremity amputation in their last year of life compared with 1% of 958,412 beneficiaries without ESRD. Adjusted analyses of patients with ESRD showed that those who had undergone lower extremity amputation were substantially more likely than those who had not to have been admitted to—and to have had prolonged stays in—acute and subacute care settings during their final year of life. Amputation was also associated with a greater likelihood of dying in the hospital, dialysis discontinuation before death, and less time receiving hospice services.ConclusionsNearly one in ten patients with ESRD undergoes lower extremity amputation in their last year of life. These patients have prolonged stays in acute and subacute health care settings and appear to have limited access to hospice services. These findings likely signal unmet palliative care needs among seriously ill patients with ESRD who undergo amputation as well as opportunities to improve their care.

scholarly journals National and State-Level Trends in Nontraumatic Lower-Extremity Amputation Among U.S. Medicare Beneficiaries With Diabetes, 2000–2017

Diabetes Care ◽  
2020 ◽  
Vol 43 (10) ◽  
pp. 2453-2459 ◽  
Author(s):  
Jessica L. Harding ◽  
Linda J. Andes ◽  
Deborah B. Rolka ◽  
Giuseppina Imperatore ◽  
Edward W. Gregg ◽  
...  
Keyword(s):  
Lower Extremity ◽  
State Level ◽  
Lower Extremity Amputation ◽  
Medicare Beneficiaries ◽  
Extremity Amputation

106-OR: National Trends in Lower Extremity Amputation among U.S. Medicare Beneficiaries with Diabetes, 2000-2017

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 106-OR
Author(s):  
JESSICA HARDING ◽  
LINDA J. ANDES ◽  
DEBORAH B. ROLKA ◽  
GIUSEPPINA IMPERATORE ◽  
YANFENG LI ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Lower Extremity Amputation ◽  
Medicare Beneficiaries ◽  
National Trends ◽  
Extremity Amputation

scholarly journals Peripheral Arterial Testing Before Lower Extremity Amputation Among Medicare Beneficiaries, 2000 to 2010

2014 ◽  
Vol 7 (1) ◽  
pp. 142-150 ◽  
Author(s):  
S. Vemulapalli ◽  
M. A. Greiner ◽  
W. S. Jones ◽  
M. R. Patel ◽  
A. F. Hernandez ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Lower Extremity Amputation ◽  
Medicare Beneficiaries ◽  
Peripheral Arterial ◽  
Extremity Amputation

Review of Research on Prosthetic Devices for Lower Extremity Amputation

2006 ◽  
Vol 34 (5) ◽  
pp. 379-438 ◽  
Author(s):  
Diane M. Collins ◽  
Amol Karmarkar ◽  
Rick Relich ◽  
Paul F. Pasquina ◽  
Rory A. Cooper
Keyword(s):  
Lower Extremity ◽  
Lower Extremity Amputation ◽  
Prosthetic Devices ◽  
Extremity Amputation

1497-P: Secular Trends in Incidence and One-Year Mortality Rates of Lower Extremity Amputation in People with Diabetes in Hong Kong between 2001 and 2016

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1497-P
Author(s):  
HONGJIANG WU ◽  
AIMIN YANG ◽  
ERIC S. LAU ◽  
RONALD C. MA ◽  
ALICE P. KONG ◽  
...  
Keyword(s):  
Hong Kong ◽  
Lower Extremity ◽  
Mortality Rates ◽  
Secular Trends ◽  
Lower Extremity Amputation ◽  
One Year ◽  
Extremity Amputation

Lower-extremity amputation. Incidence, risk factors, and mortality in the Oklahoma Indian Diabetes Study

Diabetes ◽  
1993 ◽  
Vol 42 (6) ◽  
pp. 876-882 ◽  
Author(s):  
J. S. Lee ◽  
M. Lu ◽  
V. S. Lee ◽  
D. Russell ◽  
C. Bahr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Lower Extremity Amputation ◽  
Incidence Risk ◽  
Extremity Amputation

Does Perioperative Hemoglobin A1c Level Affect the Incidence, Pattern and Mortality of Lower Extremity Amputation?

2019 ◽  
Vol 17 (4) ◽  
pp. 354-364
Author(s):  
Hassan Al-Thani ◽  
Moamena El-Matbouly ◽  
Maryam Al-Sulaiti ◽  
Noora Al-Thani ◽  
Mohammad Asim ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Lower Extremity ◽  
Hazard Ratio ◽  
Lower Extremity Amputation ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Extremity Amputation ◽  
Group 1

Background: We hypothesized that perioperative HbA1c influenced the pattern and outcomes of Lower Extremity Amputation (LEA). Methods: A retrospective analysis was conducted for all patients who underwent LEA between 2000 and 2013. Patients were categorized into 5 groups according to their perioperative HbA1c values [Group 1 (<6.5%), Group 2 (6.5-7.4%), Group 3 (7.5-8.4%), Group 4 (8.5-9.4%) and Group 5 (≥9.5%)]. We identified 848 patients with LEA; perioperative HbA1c levels were available in 547 cases (Group 1: 18.8%, Group 2: 17.7%, Group 3: 15.0%, Group 4: 13.5% and Group 5: 34.9%). Major amputation was performed in 35%, 32%, 22%, 10.8% and 13.6%, respectively. Results: The overall mortality was 36.5%; of that one quarter occurred during the index hospitalization. Mortality was higher in Group 1 (57.4%) compared with Groups 2-5 (46.9%, 38.3%, 36.1% and 31.2%, respectively, p=0.001). Cox regression analysis showed that poor glycemic control (Group 4 and 5) had lower risk of mortality post-LEA [hazard ratio 0.57 (95% CI 0.35-0.93) and hazard ratio 0.46 (95% CI 0.31-0.69)]; this mortality risk persisted even after adjustment for age and sex but was statistically insignificant. The rate of LEA was greater among poor glycemic control patients; however, the mortality was higher among patients with tight control. Conclusion: The effects of HbA1c on the immediate and long-term LEA outcomes and its therapeutic implications need further investigation.

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