Diabetes and vulnerabilities in people undergoing lower-extremity amputation

Area of Science:

• Medical Research
• Public Health
• Epidemiology

Background:

• Limited data exists on the characteristics of individuals undergoing major lower-extremity amputation (LEA) in Denmark.
• This study addresses this gap by examining socioeconomic factors, comorbidities, healthcare utilization, and mortality among LEA patients.

Purpose of the Study:

• To describe the socioeconomic and demographic profiles of individuals undergoing major lower-extremity amputation (LEA).
• To investigate the prevalence of comorbidities, healthcare contacts, and mortality rates in the LEA population.
• To compare these characteristics against a matched reference group from the general population.

Main Methods:

• A descriptive observational study utilizing the National Patient Registry for major non-traumatic lower-extremity amputations (2019-2021).
• Classification of patients based on diabetes status (no diabetes, type 1 diabetes, type 2 diabetes).
• Matching LEA patients with a general population cohort and linking administrative registry data for comprehensive analysis.

Main Results:

• The study identified 3,088 individuals with major LEA, with 39.3% having type 2 diabetes.
• Compared to controls, LEA patients showed higher rates of single status, basic education, low income, and non-urban residence.
• The LEA population experienced high comorbidity (85.1% cardiovascular disease), frequent healthcare contacts, and elevated 30-day (15.8%) and one-year (29.3%) mortality.

Conclusions:

• Approximately 40% of major lower-extremity amputation patients have diabetes.
• Significant social inequalities, increased comorbidity, and higher mortality are evident in the LEA population.
• The findings highlight disparities and increased healthcare needs among individuals undergoing major LEA.