The relationship between lower extremity amputation and body mass index.

Area of Science:

• Medical research
• Public health
• Obesity studies

Background:

• Non-traumatic lower extremity amputation (LEA) is linked to high morbidity and mortality.
• Diabetes mellitus (DM) and peripheral vascular disease (PVD) are primary risk factors for LEA.
• Obesity is strongly associated with DM and PVD, suggesting a role in LEA risk.

Purpose of the Study:

• To investigate the relationship between body mass index (BMI) and non-traumatic lower extremity amputation (LEA).
• To identify predictors and risk factors associated with LEA in a large patient cohort.

Main Methods:

• Retrospective analysis of 16,259 patients undergoing non-traumatic LEA from 2008-2014 using the National Inpatient Sample (NIS) database.
• Patients categorized by BMI: Non-obese (<30), Obesity Class I (30-34.9), Class II (35-39.9), and Class III (≥40).
• Chi-square tests, binary logistic regression, and multivariate analysis used to compare predictors and assess LEA risk factors.

Main Results:

• A V-shaped trend observed in LEA rates across BMI categories, with highest rates in non-obese and obesity class III.
• Higher BMI correlated with increased diabetes incidence but decreased PVD incidence.
• Inverse relationship between LEA rates and BMI observed in patients with DM and those with both DM and PVD; higher BMI showed lower LEA rates.
• Lower household income and comorbidities (PVD, DM, renal failure, hypertension) significantly increased LEA odds.
• Obesity class III patients had significantly lower odds of LEA (OR 0.52) compared to non-obese individuals.

Conclusions:

• Elevated BMI and female gender demonstrate a protective effect against non-traumatic LEA.
• Predisposing factors for LEA include lower socioeconomic status and comorbidities such as PVD, DM, renal failure, and hypertension.
• Findings highlight the need for further research to develop targeted management guidelines for high-risk populations.