All-cause mortality after diabetes-related amputation in Barbados: a prospective case-control study

To determine the mortality rate after diabetes-related lower-extremity amputation (LEA) in an African-descent Caribbean population. We conducted a prospective case-control study. We recruited case subjects (with diabetes and LEA) and age-matched control subjects (with diabetes and no LEA) between 19...

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Vydáno v:Diabetes care Ročník 32; číslo 2; s. 306 - 307
Hlavní autoři: Hambleton, Ian R, Jonnalagadda, Ramesh, Davis, Christopher R, Fraser, Henry S, Chaturvedi, Nish, Hennis, Anselm J
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States American Diabetes Association 01.02.2009
Témata:
Africans
Age differences
Aged
amputation
Amputation - classification
Amputation - mortality
Amputation, Surgical
Barbados
Barbados - epidemiology
Black People
Blacks - statistics & numerical data
Caribbean
Case-Control Studies
classification
death
Deaths
Diabetes
Diabetic Foot
Diabetic Foot - surgery
epidemiology
Epidemiology/Health Services Research
Foot diseases
Health care access
Humans
Industrialized nations
Mortality
Postoperative Complications
Postoperative Complications - classification
Postoperative Complications - mortality
Prospective Studies
risk
Risk factors
Statistical methods
statistics & numerical data
surgery
Survival Rate
Barbados
Caribbean
ISSN:0149-5992, 1935-5548, 1935-5548
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Shrnutí:To determine the mortality rate after diabetes-related lower-extremity amputation (LEA) in an African-descent Caribbean population. We conducted a prospective case-control study. We recruited case subjects (with diabetes and LEA) and age-matched control subjects (with diabetes and no LEA) between 1999 and 2001. We followed these groups for 5 years to assess mortality risk and causes. There were 205 amputations (123 minor and 82 major). The 1-year and 5-year survival rates were 69 and 44% among case subjects and 97 and 82% among control subjects (case-control difference, P < 0.001). The mortality rates (per 1,000 person-years) were 273.9 (95% CI 207.1-362.3) after a major amputation, 113.4 (85.2-150.9) after a minor amputation, and 36.4 (25.6-51.8) among control subjects. Sepsis and cardiac disease were the most common causes of death. These mortality rates are the highest reported worldwide. Interventions to limit sepsis and complications from cardiac disease offer a huge potential for improving post-LEA survival in this vulnerable group.
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Published ahead of print at http://care.diabetesjournals.org on 4 November 2008.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
ISSN:0149-5992
1935-5548
1935-5548
DOI:10.2337/dc08-1504