Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, and Unit of Orthopaedics, Södersjukhuset, SE-118 83 Stockholm, Sweden.
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, and Unit of Orthopaedics, Södersjukhuset, SE-118 83 Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76 Stockholm, Sweden.
Diabetes Res Clin Pract. 2018 Sep;143:225-231. doi: 10.1016/j.diabres.2018.07.016. Epub 2018 Jul 29.
Transfemoral amputation (TFA) is associated with a high postoperative mortality though it is unclear whether diabetes is associated with an increased mortality or not. The aim was to examine mortality at 1 week and 1 year after first-ever TFA with special reference to diabetes.
We included 162 first-ever TFAs from 1996 to 2012. Mortality data were collected with the use of the Swedish personal identification number.
The median age was 85 years. Diabetes mellitus were present in 19% (n = 30) of the patients and 67% (n = 109) had cardiovascular disease. Mortality was significantly higher for patients with diabetes compared to patients without diabetes at 1 week (30% vs. 8%, p = 0.001) and at 1 year (80% vs. 57%, p = 0.02). This difference was significant in multivariable analysis.
We conclude that postoperative mortality was high. The high mortality rate emphasizes the need for early and adequate evaluation of every patient́s overall condition and whether amputation is beneficial or not. Although further studies are needed to analyze the specific causes of early death in amputees and we suggest close monitoring of blood-sugar in patients with diabetes and early treatment of infections and cardiac events in all patients.
股部截肢（TFA）术后死亡率较高，但尚不清楚糖尿病是否与死亡率增加有关。本研究旨在探讨首次 TFA 后 1 周和 1 年的死亡率，并特别关注糖尿病的影响。
我们纳入了 1996 年至 2012 年期间的 162 例首次股部截肢患者。使用瑞典个人身份证号码收集死亡率数据。
患者的中位年龄为 85 岁。19%（n=30）的患者患有糖尿病，67%（n=109）患有心血管疾病。与无糖尿病患者相比，糖尿病患者在术后 1 周（30% vs. 8%，p=0.001）和 1 年（80% vs. 57%，p=0.02）的死亡率显著更高。多变量分析结果一致。
我们得出结论，术后死亡率较高。高死亡率强调了对每位患者整体状况的早期和充分评估，以及截肢是否有益。尽管需要进一步研究来分析截肢患者早期死亡的具体原因，但我们建议密切监测糖尿病患者的血糖，并对所有患者的感染和心脏事件进行早期治疗。
