Epidemiology of major amputation following diabetic foot ulcer: Insights from recent nationwide data in the french national health registry (SNDS)
Authors' conclusion
This is the first national study of the care pathways followed by people with DFU. Failures in the care pathway, precariousness and several comorbidities were identified, with an impact on the MA risk.
Study context
- Population
- People living with diabetes and incident DFU, France, 2018
- Participants
- 133,791 people
- Outcome
- Occurrence of major lower limb amputation (MA)
- Follow-up
- Within one year
Methodological detailsFrench National Health Data System (SNDS)
- French National Health Data System (SNDS)
Main finding
As reported in the abstract
Major lower limb amputation · during follow-up
MA performed
4,733
3.5 %
Observational data: associations, not effects.
Further findings
Factors associated with MA
- Male sex, HR [95% CI]
- 1.92 [1.78;2.08]
- Lower limb arteriopathy, HR [95% CI]
- 10.16 [9.36;11.03]
- Psychiatric disease, HR [95% CI]
- 1.10 [1.01;1.20]
- End-stage renal disease, HR [95% CI]
- 2.12 [1.93;2.33]
Care pathway and MA (lower MA rates with more visits)
- More general practitioner visits, HR [95% CI]
- 0.83 [0.75-0.91]
- More private nurse visits, HR [95% CI]
- 0.88 [0.81-0.95]
- More diabetologist visits, HR [95% CI]
- 0.88 [0.81-0.95]
Deprivation and MA
- Living in most disadvantaged municipalities (higher MA rate), HR [95% CI]
- 1.17[1.06-1.29]
People with MA included via out-of-hospital part of protocol, first hospital contact led to MA
- Proportion of people with MA
- 16.4 %
Original publication
Epidemiology of major amputation following diabetic foot ulcer: Insights from recent nationwide data in the french national health registry (SNDS). Diabetes Metab. Published 13 January 2025. doi:10.
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