Calle-Pascual A L, Redondo M J, Ballesteros M, Martinez-Salinas M A, Diaz J A, De Matias P, Calle J R, Gil E, Jimenez M, Serrano F J, Martin-Alvarez P J, Maranes J P
Servicio de Endocrinologia, Metabolismo y Nutrición, Hospital Universitario S. Carlos, Madrid, Spain.
Diabetes Metab. 1997 Dec;23(6):519-23.
The purpose of this study was to determine the incidence of non-traumatic lower extremity amputations (LEAs) in diabetic and non-diabetic subjects in Madrid, Spain, and their direct cost. All patients who underwent LEAs between the 1st of January 1994 and the 31st of December 1996, and who had lived in area 7 of the city (569,307 inhabitants) for at least the last 6 months, were identified through operating theatre records cross-checked with Vascular Surgery Department discharge records. In addition, the direct cost of LEAs per year was estimated, taking into account the length of the hospital stay, the period of rehabilitation in the outpatient clinic after discharge, and the use of artificial limbs and their maintenance. The incidence of LEAs was 1.6 (95% CI: 1.1-2.2) per 10(5) non-diabetic subjects and 46.1 (95% CI: 34.5-57.6) per 10(5) diabetic patients. Relative risk was 28. Total direct costs associated with LEAs per year were US$ 56,131 in the diabetic population and US$ 30,765 in the non-diabetic population. Thus, potential cost savings associated with excess amputations in the diabetic population was estimated at US$ 541,353 per year of US$ 94,736 per 10(5) inhabitants. It is concluded that the incidence of LEAs in both diabetic and non-diabetic populations in area 7 is the lowest reported in European countries. The potential cost savings per 10(5) inhabitants and per year is estimated at US$ 94,736.
本研究的目的是确定西班牙马德里糖尿病患者和非糖尿病患者非创伤性下肢截肢（LEA）的发生率及其直接成本。通过手术室记录与血管外科出院记录交叉核对，确定了所有在1994年1月1日至1996年12月31日期间接受LEA手术、且至少在该市第7区（569,307名居民）居住了6个月的患者。此外，还估算了每年LEA的直接成本，其中考虑了住院时间、出院后门诊康复时间以及假肢的使用和维护费用。非糖尿病患者中LEA的发生率为每10（5）人中有1.6例（95%可信区间：1.1 - 2.2），糖尿病患者中为每10（5）人中有46.1例（95%可信区间：34.5 - 57.6）。相对风险为28。糖尿病患者每年与LEA相关的总直接成本为56,131美元，非糖尿病患者为30,765美元。因此，糖尿病患者因截肢过多而可能节省的成本估计为每年541,353美元，即每10（5）名居民中节省94,736美元。结论是，第7区糖尿病和非糖尿病人群中LEA的发生率是欧洲国家报道中最低的。每10（5）名居民每年潜在的成本节省估计为94,736美元。
