Lower Extremity Amputation-incidence and Review of Diabetic and Non-diabetic Patients in Central Slovenia Population from 2001 to 2019

  • Igor Frangež, * Department for Surgical Infections, University Medical Center Ljubljana, & Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia https://orcid.org/0000-0001-9963-8810
  • Tea Nizič-Kos Institute of Oncology Ljubljana, Department of Surgery, Ljubljana, Slovenia
  • Nadja Alikadic Department for Surgical Infections, University Medical Center Ljubljana, Ljubljana, Slovenia
Keywords: Lower Extremity, Amputation, Diabetes Mellitus, Peripheral Vascular Disease

Abstract

Introduction: This retrospective study aimed to determine the trends in the incidence of non-traumatic lower extremity amputations in diabetic and non-diabetic patients.
Methods: A retrospective, population-based cohort study was conducted at the University Medical Center Ljubljana which is representative of Slovenia. By defined inclusion criteria, we gathered information on patients treated for lower extremity amputations over 19 years (2001 - 2019). Patients were divided into two groups, diabetics and non-diabetics. Linear regression analysis was used to analyze amputation trends over the studied years.
Results: A total of 2,341 patients were included in our study, the majority were diabetics (1412/2341; 60.32%). Our results revealed an increased incidence of lower extremity amputations in diabetic and non-diabetic patients alike. The age- and gender-adjusted relative increase in amputation rates were 45% in all amputations and 35% in major amputations (P < 0.001). Non-diabetics were slightly older (2 years on average; P < 0.05), with a higher mortality rate (6.1% vs. 1.8%; P < 0.05).
Conclusions: Despite efforts to reduce lower extremity amputations in diabetics, their incidence in Slovenia is increasing. Higher amputation rates can only partially be justified by an aging population and an increasing number of diabetics. Preventive measures for amputation amply described in the literature are available and implemented also in our country, but considering our results, they need to be re-evaluated.

Author Biography

Igor Frangež, *, Department for Surgical Infections, University Medical Center Ljubljana, & Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

E-mail: igor.frangez@kclj.si, Tel: +386 1 522 23 19

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Published
2022-01-04
Section
Original Article