Comorbid status in patients with osteomyelitis is associated with long-term incidence of extremity amputation
Authors' conclusion
Patients with osteomyelitis have higher rates of amputation and hospitalization. Clinicians must incorporate demographic and comorbid risk factors to protect against amputation.
Study context
- Population
- Inpatients with osteomyelitis between 2004 and 2015, stratified by osteomyelitis location
- Participants
- 1,186 inpatients
- Exposure
- Diabetes and other demographic and comorbid risk factors vs their absence
- Outcome
- Incidence of amputation
- Follow-up
- 2 years
Main finding
As reported in the abstract
Amputation
- Lower extremity amputation with diabetes: 3.65 times greater probability, adjusted
- p<0.001
- Male gender, amputation
- RR 1.57, p<0.001
- Black race, amputation
- RR 1.41, p<0.05
- Former smoking, amputation
- RR 1.38, p<0.01
- MI, amputation
- RR 1.72, p<0.001
- Congestive HF, amputation
- RR 1.56, p<0.001
- Peripheral vascular disease, amputation
- RR 2.25, p<0.001
- Renal disease, amputation
- RR 1.756, p<0.001
Observational data: associations, not effects.
Further findings
Lower, not upper, extremity amputation
- Male gender
- RR 1.39, p<0.01
- Black race
- RR 1.27, p<0.05
- Diabetes
- RR 2.77, p<0.001
- Peripheral vascular disease
- RR 1.59, p<0.001
Readmission and inpatient stay with diabetes
- Readmission higher with diabetes
- P < 0.001
- Longer inpatient stay with diabetes
- P < 0.001
- Adjusting for risk factors
2-year mortality with diabetes
- Higher 2-year mortality with diabetes
- RR 1.23, p=0.0027
- Adjusting for risk factors
Original publication
Comorbid status in patients with osteomyelitis is associated with long-term incidence of extremity amputation. BMJ Open Diabetes Res Care. Published 12 December 2023. doi:10.
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