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. 2021 Jul 24:2021:8866126.
doi: 10.1155/2021/8866126. eCollection 2021.

Amputations of Lower Limb in Subjects with Diabetes Mellitus: Reasons and 30-Day Mortality

Magdalena Walicka  1   2 , Marta Raczyńska  3 , Karolina Marcinkowska  3 , Iga Lisicka  3 , Arthur Czaicki  1 , Waldemar Wierzba  4 , Edward Franek  1   2
Affiliations

Amputations of Lower Limb in Subjects with Diabetes Mellitus: Reasons and 30-Day Mortality

Magdalena Walicka et al. J Diabetes Res. .

Abstract

Background: Diabetic foot is one of the leading causes of patient disability worldwide. Lower-extremity amputations (LEAs) resulting from this disease massively decrease quality of life, the function of the patient, and incur significant healthcare costs. The aim of this study was to assess trends in the number of amputations, the diagnosis at discharge, and diagnosis-related mortality after LEA procedures in a nationwide population.

Methods: Datasets of the National Heath Fund containing information about all services within the public healthcare system in Poland, spanning the years 2010-2019, were analyzed. The source of data regarding mortality was the database of the Polish Ministry of Digital Affairs.

Results: Between 2010 and 2019, the annual number of amputations in patients with diabetes increased significantly from 5,049 to 7,759 (p for trend < 0.000001). However, the number of amputations in patients with diabetes calculated as a number per 100,000 diabetics decreased significantly (p for trend < 0.0005) during this period. Amputations in patients with diabetes accounted for a majority of all amputations; the mean percentage of amputations in patients with diabetes was 68.6% of all amputations (from 61.1% in 2010 to 71.4% in 2019, p for trend < 0.0000001). The most common disease diagnosed at discharge after LEA in diabetic patients was diabetes itself. Vascular pathologies, such as soft-tissue/bone/joint infections and ulcerations, were the next most common. The 30-day mortality rate after LEA was rather high in patients with, as well as without, diabetes (depending on the cause for amputation 3.5-34% and 2.2-28.99%, respectively).

Conclusions: The number of LEA in patients with diabetes in Poland increased substantially between 2010 and 2019 along with an increasing number of diabetics. Vascular pathologies, infections, and ulcerations were the most common causes of LEA. The 30-day mortality rate after amputation was rather high and varied depending on the diagnoses at discharge.

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Conflict of interest statement

Edward Franek is a coauthor of one publication with the guest editor of this issue of JDR. Other authors do not disclose any conflicts of interest with regard to this study.

Figures

Figure 1
Figure 1
(a) Absolute number of amputations in patients with and without diabetes, and (b) number of amputations in patients with diabetes per 100,000 diabetics, and in patients without diabetes per 100,000 inhabitants in the years 2010-2019.
Figure 2
Figure 2
(a) Percentage number of ICD-10 categories given as the main diagnosis at the discharge from the hospital after the amputation in all study population and (b) in population after excluding the patients in whom the main diagnosis at the discharge was diabetes.
See this image and copyright information in PMC

References

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