Long-term mortality rates after lower extremity amputation in individuals with and without diabetes mellitus (DUDE-10): A retrospective matched cohort study

IF 3.1 3区医学 Q3 ENDOCRINOLOGY & METABOLISM Journal of diabetes and its complications Pub Date : 2025-03-01 Epub Date: 2025-02-01 DOI:10.1016/j.jdiacomp.2025.108956

L. Rosien , H.J.G. Bilo , J. Oskam , D. Ruwaard , R.O.B. Gans , M.A. Edens , M.J. Molegraaf , P.R. van Dijk

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Abstract

Background/objectives

To determine mortality rates after lower extremity amputation (LEA) in individuals with and without diabetes mellitus (DM).

Methods

Retrospective, observational study using data from a database covering >99 % of the Dutch population. LEAs in 2016 were identified, and mortality data from 2016 to 2021 were analyzed. Study group 1 (SG1) included individuals with DM and LEA (DM+/LEA+) with two control groups (CG), DM+/LEA− (matched by age, sex, without (1a) and with (1b) socioeconomic status matching). Study group 2 (SG2) (DM+/LEA+) was composed after matching with non-DM individuals with LEA (DM−/LEA+ (2a)).

Results

Among 5145 individuals with LEA in 2016, 56 % had DM. Five-year mortality was 61.2 % in SG1 (DM+/LEA+) and 27.9 % in CG1a (DM+, LEA−) and 1b. Study group 2 (DM+/LEA+) had a 62.6 % five-year mortality rate, compared to 56.4 % in CG2a (DM−/LEA+).

Conclusions

Mortality after LEA is high, especially in DM; socioeconomic status (SES) does not significantly impact mortality.

Level of evidence

Level III retrospective cohort study.

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糖尿病患者和非糖尿病患者下肢截肢后的长期死亡率（DUDE-10）：一项回顾性匹配队列研究

背景/目的探讨糖尿病患者和非糖尿病患者下肢截肢（LEA）后的死亡率。方法回顾性观察性研究，使用数据库中的数据，涵盖99%的荷兰人口。确定2016年的LEAs，分析2016 - 2021年的死亡率数据。研究组1 （SG1）包括DM和LEA患者（DM+/LEA+）和两个对照组（CG）， DM+/LEA−（按年龄、性别匹配，无（1a）和有（1b）社会经济地位匹配）。研究组2 (SG2) （DM+/LEA+）与非DM个体（DM−/LEA+ (2a)）进行LEA匹配后组成。结果2016年5145例LEA患者中，56%为DM， SG1 （DM+/LEA+）患者5年死亡率为61.2%,CG1a （DM+、LEA−）和1b患者5年死亡率为27.9%。研究2组（DM+/LEA+）的5年死亡率为62.6%，而CG2a组（DM−/LEA+）的5年死亡率为56.4%。结论LEA术后死亡率高，糖尿病患者死亡率最高；社会经济地位（SES）对死亡率没有显著影响。证据水平：III级回顾性队列研究。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.