糖尿病患者与非糖尿病患者下肢截肢后的长期死亡率（DUDE - 10）：一项回顾性匹配队列研究
Long-term mortality rates after lower extremity amputation in individuals with and without diabetes mellitus (DUDE-10): A retrospective matched cohort study.
作者信息
Rosien L, Bilo H J G, Oskam J, Ruwaard D, Gans R O B, Edens M A, Molegraaf M J, van Dijk P R
机构信息
Diabetes Center, Isala Dr Stolteweg 2, 8025 AB Zwolle, the Netherlands; Innofeet, Faradaystraat 7, 8013 PH Zwolle, the Netherlands; Department of Internal Medicine, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Research Center for Chronic Diseases, Dokter van Deenweg 1-11, 8025 BP Zwolle, the Netherlands.
Department of Internal Medicine, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Research Center for Chronic Diseases, Dokter van Deenweg 1-11, 8025 BP Zwolle, the Netherlands.
出版信息
J Diabetes Complications. 2025 Mar;39(3):108956. doi: 10.1016/j.jdiacomp.2025.108956. Epub 2025 Feb 1.
BACKGROUND/OBJECTIVES: To determine mortality rates after lower extremity amputation (LEA) in individuals with and without diabetes mellitus (DM).
METHODS
Retrospective, observational study using data from a database covering >99 % of the Dutch population. LEAs in 2016 were identified, and mortality data from 2016 to 2021 were analyzed. Study group 1 (SG1) included individuals with DM and LEA (DM+/LEA+) with two control groups (CG), DM+/LEA- (matched by age, sex, without (1a) and with (1b) socioeconomic status matching). Study group 2 (SG2) (DM+/LEA+) was composed after matching with non-DM individuals with LEA (DM-/LEA+ (2a)).
RESULTS
Among 5145 individuals with LEA in 2016, 56 % had DM. Five-year mortality was 61.2 % in SG1 (DM+/LEA+) and 27.9 % in CG1a (DM+, LEA-) and 1b. Study group 2 (DM+/LEA+) had a 62.6 % five-year mortality rate, compared to 56.4 % in CG2a (DM-/LEA+).
CONCLUSIONS
Mortality after LEA is high, especially in DM; socioeconomic status (SES) does not significantly impact mortality.
LEVEL OF EVIDENCE
Level III retrospective cohort study.
背景/目的：确定患有和未患有糖尿病（DM）的个体下肢截肢（LEA）后的死亡率。
方法
采用来自覆盖荷兰99%以上人口的数据库数据进行回顾性观察研究。确定2016年的下肢截肢病例，并分析2016年至2021年的死亡率数据。研究组1（SG1）包括患有糖尿病和下肢截肢的个体（DM+/LEA+），有两个对照组（CG），DM+/LEA-（按年龄、性别匹配，不匹配社会经济地位（1a）和匹配社会经济地位（1b））。研究组2（SG2）（DM+/LEA+）是在与非糖尿病下肢截肢个体（DM-/LEA+（2a））匹配后组成的。
结果
2016年5145例下肢截肢个体中，56%患有糖尿病。研究组1（DM+/LEA+）的五年死亡率为61.2%，对照组1a（DM+，LEA-）和1b为27.9%。研究组2（DM+/LEA+）的五年死亡率为62.6%，而对照组2a（DM-/LEA+）为56.4%。
结论
下肢截肢后的死亡率很高，尤其是在糖尿病患者中；社会经济地位（SES）对死亡率没有显著影响。
证据水平
III级回顾性队列研究。
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