[Lower-limb amputations and diabetes].

BACKGROUND

A reduced incidence of lower-limb amputations in diabetic patients is a highly prioritised goal. The frequency and prognosis of amputations in our hospital area was recorded in the present study.

MATERIAL AND METHODS

All patient records from 1990 to 1999 from the hospitals in Hamar and Elverum, with operation codes for lower-limb amputations, were examined. Known diabetes, smoking status, previous angiography or vascular surgery, and survival until January 31st 2002 were recorded.

RESULTS

412 amputations in 270 patients were recorded. 118 patients (44%) had diabetes, 96% of them had diabetes type 2. Diabetic patients were subject to 51% of the amputations. On average, 0.31% of known diabetic patients in our hospital area had amputations of lower-limb(s) annually during the study period. The mean annual incidence of amputations in diabetic persons was 550 per 100,000 and in non-diabetics 17 per 100,000. The mean age at the first amputation was 77 years. Multiple and distal operations were more frequent in diabetics. Mortality 30 days after the first amputation was 11% in diabetics and 24% in non-diabetics and after one year it was 32% for diabetics and 51% for non-diabetics.

INTERPRETATION

The amputation frequency in our hospital area is similar to that in other parts of Norway. About one half of lower-limb amputations are performed in diabetic patients. Most amputees are old and mortality after amputation is high.