Wierzba Waldemar, Krasnodębski Przemysław, Śliwczyński Andrzej, Karnafel Waldemar
University of Humanities and Economics, Łódź, Satellite Campus, Warsaw, Poland.
Department of Gastroenterology and Metabolic Diseases, Medical University, Warsaw, Poland.
Ann Agric Environ Med. 2020 Mar 17;27(1):76-79. doi: 10.26444/aaem/114725. Epub 2019 Dec 11.
High amputation of the lower limb not only causes immense physical disability but also the destruction of the patient's mental state, and helps to shorten life of patients with diabetes. The incidence of amputations in diabetic patients is 10 times higher in comparison to non-diabetic subjects (2.8% vs. 0.29%). The purpose of the study is an analysis of the geographic variability of major non-traumatic lower limb amputation in diabetic and non-diabetic patients in Poland.
All major non-traumatic lower limb amputations performed for the first time, in particular databetween 1 January 2013 - 31 December 2013, and between 1 January 2014 - December 2014, were identified in the National Health Fund (NHF) database. In the presented study, the patients were grouped in relevant provincial departments of the NHF according to their place of residence, and not according to the hospital where lower limb amputation was performed.
In 2013 in Poland, 4,727 major non-traumatic lower limb amputation were performed in diabetic patients, and 4,350 in 2014. On the other hand, in non-diabetic patients, 3,469 major non-traumatic lower limb amputations were performed in 2013, and 3149 in 2014. The mean number indicator of major non-traumatic lower limb amputations in diabetic patients in Poland, compared to the average indicator of amputations in patients without diagnosed diabetes in Poland was 19.9-fold in 2013 and 19.4-fold higher in 2014.
In populations of diabetic patients and individuals without diagnosed diabetes major non-traumatic lower limb amputations are performed over 19-fold more frequently.
下肢高位截肢不仅会导致严重的身体残疾，还会破坏患者的精神状态，并且会缩短糖尿病患者的寿命。糖尿病患者截肢的发生率是非糖尿病患者的10倍（2.8%对0.29%）。本研究的目的是分析波兰糖尿病患者和非糖尿病患者主要非创伤性下肢截肢的地理变异性。
在国家卫生基金（NHF）数据库中识别出所有首次进行的主要非创伤性下肢截肢手术，特别是2013年1月1日至2013年12月31日以及2014年1月1日至2014年12月期间的手术。在本研究中，患者根据其居住地在NHF的相关省级部门进行分组，而不是根据进行下肢截肢手术的医院进行分组。
2013年在波兰，糖尿病患者进行了4727例主要非创伤性下肢截肢手术，2014年为4350例。另一方面，非糖尿病患者在2013年进行了3469例主要非创伤性下肢截肢手术，2014年为3149例。与波兰未诊断出糖尿病的患者截肢平均指标相比，2013年波兰糖尿病患者主要非创伤性下肢截肢的平均数量指标高19.9倍，2014年高19.4倍。
在糖尿病患者群体和未诊断出糖尿病的个体中，主要非创伤性下肢截肢的发生率要高出19倍多。
