The impact of diabetes on mortality rates after lower extremity amputation
Authors' conclusion
In the first six postoperative months, mortality rates after LEA were not different between individuals with or without diabetes; later, diabetes was significantly associated with increased mortality. However, as HRs for mortality were higher in amputation-free individuals, diabetes impacts mortality less in the minor and major amputation groups relative to the comparison group of individuals without LEA.
Study context
- Population
- Individuals who underwent minor or major lower extremity amputation (LEA) in Belgium, 2009–2018; matched amputation-free individuals with or without diabetes for comparison41,304 amputations
- Exposure
- Diabetes vs no diabetes after minor and major LEA
- Outcome
- Mortality after LEA
Methodological detailsmatched amputation-free comparison individuals, Cox regression with time-varying coefficients, Kaplan-Meier survival analysis
- Matched amputation-free comparison individuals
- Cox regression with time-varying coefficients
- Kaplan-Meier survival analysis
Main finding
As reported in the abstract
Hazard ratio
1.38 to 1.52
all p ≤ 0.005
after minor LEA, beyond first 6 postoperative months (range)
Hazard ratio
1.35 to 1.46
all p ≤ 0.005
after major LEA, beyond first 6 postoperative months (range)
Observational data: associations, not effects.
Further findings
5-year mortality after minor LEA
5-year mortality after major LEA
Mortality hazard ratios (HRs) for diabetes vs no diabetes in individuals without LEA
- HRs systematically higher than the HRs after minor and major LEA
1-year survival trend 2009–2018
- 1-year survival rates did not change for individuals with diabetes
Original publication
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