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Mortality in diabetic patients after lower extremity amputations
C H Tseng1, T Y Tai, C K Chong
1Department of Internal Medicine, National Taiwan University Hospital, Taipei, R.O.C.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|October 1, 1994
Summary
Diabetic patients undergoing lower extremity amputations face high mortality, primarily due to cerebral infarction. Hypertension and coronary heart disease significantly increase the risk of fatal outcomes in these patients.
Area of Science:
- Endocrinology
- Vascular Surgery
- Public Health
Background:
- Lower extremity amputations are a serious complication of diabetes mellitus.
- Understanding mortality factors in diabetic amputees is crucial for improving patient outcomes.
Purpose of the Study:
- To identify prognostic factors and causes of death in Chinese diabetic patients after lower extremity amputations.
- To compare mortality rates and causes with the general population and other ethnic groups.
Main Methods:
- Retrospective review of medical records for 87 diabetic amputees (1982-1991).
- Data collection included demographics, medical history, amputation details, and laboratory values.
- Mortality follow-up via personal contact and government records; causes of death from certificates.
- Univariate and multivariate Cox proportional hazards models were used for analysis.
Main Results:
- 34 out of 87 diabetic amputees died within the study period.
- Cerebral infarction, infection, and diabetes mellitus were the leading causes of death.
- Mortality was 5.95 times higher than the age-comparable Taiwanese population.
- History of hypertension and coronary heart disease were significant predictors of mortality (rate ratios > 2).
Conclusions:
- Post-amputation mortality is significantly elevated in diabetic patients.
- Cerebral infarction is the primary cause of death, differing from cardiovascular disease in Caucasians.
- Hypertension and coronary heart disease are critical prognostic indicators for diabetic amputees.