Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Department of Biochemistry, University of Karachi, Karachi, Pakistan.
Curr Vasc Pharmacol. 2021;19(1):102-109. doi: 10.2174/1570161118666200320112401.
The rising prevalence of type 2 diabetes mellitus (T2DM) with the huge burden of diabetic foot amputation is a challenge to the health economy of Pakistan and other countries. Identification of various risk factors for amputation, along with its financial burden, is needed to address this problem.
This study aimed to determine the financial burden and risk factors associated with T2DMrelated foot amputation.
Retrospective hospital-based study from January 2017 to December 2018. Patients with T2DM with and without amputation were enrolled. The direct medical costs of amputation along with various risk factors, were determined. Risk factors were evaluated by logistic regression analysis.
A total of 1460 patients with T2DM were included; 484 (33%) patients had an amputation. The mean total cost of below knee, fingers and toe amputation was 886.63±23.91, 263.35 ±19.58 and 166.68 ± 8.47 US$, respectively. This difference among groups was significant (p<0.0001). Male gender (odds ratio, OR: 1.29, 1.01-1.63, p=0.037), peripheral artery disease (OR: 1.93, 1.52-2.46, p=0.000), peripheral neuropathy (OR: 1.31, 1.40-1.63, p=0.000), prior diabetic foot ulcer (OR: 2.02, 1.56- 2.56, p=0.000) and raised glycated haemoglobin (HbA1c) (OR: 3.50, 2.75-4.4, p=0.000) were risk factors for amputation.
The health-related financial impact of amputations is high. Peripheral artery disease, peripheral neuropathy, prior diabetic foot ulcer and raised HbA1c were risk factors for amputation.
2 型糖尿病（T2DM）的患病率不断上升，糖尿病足截肢的负担巨大，这对巴基斯坦和其他国家的卫生经济构成了挑战。需要确定与 T2DM 相关的足部截肢相关的各种风险因素及其经济负担，以解决这一问题。
本研究旨在确定 T2DM 相关足部截肢的经济负担和相关风险因素。
这是一项 2017 年 1 月至 2018 年 12 月的回顾性基于医院的研究。纳入了患有 T2DM 并接受和未接受截肢的患者。确定了截肢的直接医疗费用以及各种风险因素。使用 logistic 回归分析评估风险因素。
共纳入 1460 例 T2DM 患者，其中 484 例（33%）患者接受了截肢。膝下截肢、手指截肢和脚趾截肢的平均总费用分别为 886.63±23.91、263.35±19.58 和 166.68±8.47 美元，各组之间的差异有统计学意义（p<0.0001）。男性（比值比，OR：1.29，1.01-1.63，p=0.037）、外周动脉疾病（OR：1.93，1.52-2.46，p=0.000）、周围神经病变（OR：1.31，1.40-1.63，p=0.000）、既往糖尿病足溃疡（OR：2.02，1.56-2.56，p=0.000）和糖化血红蛋白（HbA1c）升高（OR：3.50，2.75-4.4，p=0.000）是截肢的风险因素。
截肢的健康相关经济影响很大。外周动脉疾病、周围神经病变、既往糖尿病足溃疡和 HbA1c 升高是截肢的风险因素。
