Schofield Christopher J, Libby Gillian, Brennan Geraldine M, MacAlpine Ritchie R, Morris Andrew D, Leese Graham P
Ward 1, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK.
Diabetes Care. 2006 Oct;29(10):2252-6. doi: 10.2337/dc06-0926.
We sought to compare the risk of mortality and hospitalization between patients with and without diabetes following incident lower-extremity amputation (LEA).
We performed a retrospective data-linkage review of all incident amputations between 1 January 1992 and 31 December 1995. Patients were categorized according to their diabetes status. Follow-up for mortality was until 1 January 2005 and until 31 March 1996 for hospitalization.
Of 390 major-incident LEAs performed during the study period, 119 (30.5%) were in patients with diabetes and 271 (69.5%) were in nondiabetic subjects. The median time to death was 27.2 months in patients with diabetes compared with 46.7 months for patients without (P = 0.01). Diabetic subjects had a 55% greater risk of death than those without diabetes. The risk of developing congestive cardiac failure with diabetes was 2.26 (95% CI 1.12-4.57) and of further amputation was 1.95 (1.14-3.33) times that of a patient without diabetes after incident LEA.
After LEA, patients with diabetes have an increased risk of death compared with nondiabetic patients. Efforts should be made to minimize these risks with aggressive treatment of cardiovascular risk factors and management of cardiac failure.
我们试图比较下肢初次截肢（LEA）后糖尿病患者与非糖尿病患者的死亡风险和住院风险。
我们对1992年1月1日至1995年12月31日期间所有初次截肢病例进行了回顾性数据关联分析。患者根据糖尿病状态进行分类。死亡率随访至2005年1月1日，住院率随访至1996年3月31日。
在研究期间进行的390例主要初次LEA中，119例（30.5%）为糖尿病患者，271例（69.5%）为非糖尿病患者。糖尿病患者的中位死亡时间为27.2个月，而非糖尿病患者为46.7个月（P = 0.01）。糖尿病患者的死亡风险比非糖尿病患者高55%。初次LEA后，糖尿病患者发生充血性心力衰竭的风险是无糖尿病患者的2.26倍（95%CI 1.12 - 4.57），再次截肢的风险是无糖尿病患者的1.95倍（1.14 - 3.33）。
LEA后，糖尿病患者的死亡风险高于非糖尿病患者。应积极治疗心血管危险因素和管理心力衰竭，努力将这些风险降至最低。
