Clinical characteristics and medical costs in patients with diabetic amputation and nondiabetic patients with nonacute amputation in central urban hospitals in China

Abstract

The objective was to analyze the clinical characteristics, amputation level, final outcome of amputation, and medical cost between diabetic amputation and nonacute amputation in China central urban hospitals. For year 2010, amputation data from 19 central municipal general hospitals located in different big cities in China were retrospectively analyzed according to a standardized protocol. A total of 308 amputation patients were recruited. The patients were divided into diabetic amputation group (n = 174) and nonacute amputation group (n = 134). A total of 27.3% of the amputated patients or 56.5% of the nonacute patients were diabetic patients. Compared with nonacute amputation, patients with diabetic amputation were older (65.4 ± 11.6 vs 55.4 ± 19.6 years, P = .000), with higher systolic blood pressure (136.7 ± 19.7 vs 132.0 ± 20.3 mm Hg, P = .044), higher fasting blood glucose level (8.3 ± 3.7 vs 5.9 ± 2.3 mmol/L, P = .000), lower triglycerides (TG; 1.3 ± 0.7 vs 1.6 ± 1.0 mmol/L, P = .014), and lower high-density lipoprotein cholesterol (HDL-C; 1.0 ± 0.4 vs 1.2 ± 0.3 mmol/L, P = .001). Minor amputation was more common in the patients with diabetic foot disease than those with nonacute foot disease (55.7% vs 20.1%; χ(2) = 40.519, P = .000). There were significant differences in days of hospital stay (33.5 vs 22.0 days) and medical cost (US$5932 vs US$4101) between the 2 groups. The patients with diabetic amputation were older with higher blood glucose, higher blood pressure, lower TG level, and lower HDL-C level. Most of them required minor amputation. More diabetic patients underwent repeated amputation. Their hospital stay was longer with significantly higher medical costs.

Keywords: amputation; diabetic foot; medical cost; nonacute.