Survival at 10 years following lower extremity amputations in patients with diabetic foot disease

Abstract

Background

Amputations are associated with markedly reduced long-term survival in patients with diabetic foot disease. However, there is paucity of long-term survival data in published literature.

Methods

We searched the electronic case records and laboratory details of patients who underwent amputations between 1997 and 2006 to obtain at least 10 years of follow up data after the surgery to assess the survival rates and possible risk factors reducing survival in the year 2016. Amputation level below ankle was considered as minor and above ankle as major amputations.

Results

Of the 233 cases (159 males; median age 68 years), 161 had major amputations. Of the 72 cases who had minor amputations initially, 63 needed a further amputation or contralateral amputation on follow up. One hundred seventy-seven patients (76%) were not alive after 10 years of follow up. The survival rates at 1, 3, 5, 7, and ≥10 years were 64%, 50%, 40%, 34%, and 24%, respectively. Maximum number of deaths occurred within 4 months of amputations. There was no difference between survival rates following major or minor amputations and among males or females. The only statistically significant parameter affecting lower survival rate was age ≥70 years, with each additional year of age increasing the hazard by a factor of 1.039 (95% CI: 1.024–1.054) or 3.9% (2.4–5.4%).

Conclusions

Five-year and 10-year survival rates were 40% and 24%, respectively, following diabetic foot amputations. Higher age ≥70 years was associated with lower survival rate compared with younger age groups after lower extremity amputations.

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Correspondence to Joseph M. Pappachan.

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This study was performed as a retrospective clinical audit at the Lancashire Teaching Hospitals NHS Trust and the Institutional Review Board had approved this audit at the time of initiation of the study and agreed for publication of the results in biomedical periodicals.

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Soo, B.P., Rajbhandari, S., Egun, A. et al. Survival at 10 years following lower extremity amputations in patients with diabetic foot disease. Endocrine 69, 100–106 (2020). https://doi.org/10.1007/s12020-020-02292-7

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Keywords

  • Diabetic foot ulcer
  • Lower extremity amputations
  • Survival rate