Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Eur J Vasc Endovasc Surg. 2013 Jul;46(1):124-31. doi: 10.1016/j.ejvs.2013.03.024. Epub 2013 Apr 28.
To determine mortality rates after a first lower limb amputation and explore the rates for different subpopulations.
Retrospective cohort study of all people who underwent a first amputation at or proximal to transtibial level, in an area of 1.7 million people. Analysis with Kaplan-Meier curves and Log Rank tests for univariate associations of psycho-social and health variables. Logistic regression for odds of death at 30-days, 1-year and 5-years.
299 people were included. Median time to death was 20.3 months (95%CI: 13.1; 27.5). 30-day mortality = 22%; odds of death 2.3 times higher in people with history of cerebrovascular disease (95%CI: 1.2; 4.7, P = 0.016). 1 year mortality = 44%; odds of death 3.5 times higher for people with renal disease (95%CI: 1.8; 7.0, P < 0.001). 5-years mortality = 77%; odds of death 5.4 times higher for people with renal disease (95%CI: 1.8; 16.0,P = 0.003). Variation in mortality rates was most apparent in different age groups; people 75-84 years having better short term outcomes than those younger and older.
Mortality rates demonstrated the frailty of this population, with almost one quarter of people dying within 30-days, and almost half at 1 year. People with cerebrovascular had higher odds of death at 30 days, and those with renal disease and 1 and 5 years, respectively.
确定首次下肢截肢后的死亡率，并探讨不同亚人群的死亡率。
对 170 万人口中在胫骨水平或其近端进行首次截肢的所有人进行回顾性队列研究。采用 Kaplan-Meier 曲线和对数秩检验分析心理社会和健康变量的单变量相关性。采用 logistic 回归分析 30 天、1 年和 5 年的死亡几率。
共纳入 299 人。中位死亡时间为 20.3 个月（95%CI：13.1；27.5）。30 天死亡率=22%；有脑血管疾病史的人死亡的几率高 2.3 倍（95%CI：1.2；4.7，P=0.016）。1 年死亡率=44%；有肾脏疾病的人死亡的几率高 3.5 倍（95%CI：1.8；7.0，P<0.001）。5 年死亡率=77%；有肾脏疾病的人死亡的几率高 5.4 倍（95%CI：1.8；16.0，P=0.003）。不同年龄组的死亡率差异最大；75-84 岁的人比年轻和年长的人短期预后更好。
死亡率表明了该人群的脆弱性，近四分之一的人在 30 天内死亡，近一半的人在 1 年内死亡。有脑血管疾病的人在 30 天内死亡的几率更高，而有肾脏疾病的人在 1 年和 5 年内死亡的几率更高。
