Aims: Lower extremity amputation (LEA) is a pivotal event for patients with diabetes. This study aimed to provide updated data on the outcomes and prognostic factors after LEA for patients with diabetes.
Methods: This retrospective cohort study included all LEAs (n = 1081) performed at Tampere University Hospital between February 2007 and September 2020. Overall survival (OS) and major amputation-free survival were evaluated.
Results: Index amputation level was below ankle in 65 % (n = 704) of patients, below knee in 14 % (n = 154) of patients, and above knee in 21 % (n = 223) of patients. In the whole population, OS was 75.8 % (CI 95 %: 73.3-78.3) at one year and 38.3 % (CI 95 %: 34.7-41.7) at five years. Higher age, peripheral artery disease (PAD), more proximal amputation level, and lower glomerular filtration rate (GFR) reduced OS. Multiple amputations and diagnosed dyslipidemia or hypertension associated with improved OS. Further, age, PAD, and GFR were identified as significant factors for major amputation free survival.
Conclusions: OS after LEA is poor. After major amputation, the risk for death is higher compared to minor amputation. Recurrent amputation is associated with improved OS. Further, ischemia and renal disease are significant factors for inferior OS.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.jdiacomp.2022.108377 | DOI Listing |
Ann Intern Med
January 2025
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California (A.B., K.J.C., A.A.K.).
Background: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) differ in their effects on body weight and risk for reoperation. However, it is unclear whether long-term health expenditures differ by procedure type in patients with diabetes.
Objective: To compare health expenditures 3 years before and 5.
Ann Intern Med
January 2025
Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.C.-P., R.B.M., C.M.P.).
Background: Prior studies indicate that 1% to 4% of Epstein-Barr virus (EBV)-seronegative recipients of EBV-seropositive donor (EBV D+/R-) kidneys develop posttransplant lymphoproliferative disorder (PTLD). However, these estimates are based on limited data that lack granularity.
Objective: To determine the associations between pretransplant EBV D+/R- and recipient EBV-seropositive status (R+) and the outcomes of PTLD and graft and patient survival among adult kidney transplant recipients.
Carbon fibre reinforced polyetheretherketone (CFR-PEEK) implants have gained interest because of reported biomechanical advantages and radio-lucent properties. The aim of this study was to evaluate the role of CFR-PEEK nails in patients with metastatic bone disease (MBD). We performed a retrospective cohort study evaluating patients with MBD undergoing intramedullary (IM) nailing for prophylaxis or fixation of pathological fractures using CFR- PEEK or titanium implants.
View Article and Find Full Text PDFCorrect treatment of chronic osteomyelitis depends on proper identification of the bone-infecting microorganism, but it is difficult identify the specific etiology in previously treated patients and in those with implants. Small colony variants auxotrophyc for menadione had been related with false-negative results in culture of patient with chronic osteomyelitis, but menadione supplementation can increase bone culture performance. The purpose was to evaluate the effect of menadione supplementation on isolates in bone cultures, in a cohort of patients with osteomyelitis, Medellín- Colombia.
View Article and Find Full Text PDFNeurology
February 2025
Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, the Netherlands.
Background And Objectives: Identifying genetic causes of dementia in patients visiting memory clinics is important for patient care and family planning. Traditional clinical selection criteria for genetic testing may miss carriers of pathogenic variants in dementia-related genes. This study aimed identify how many carriers we are missing and to optimize criteria for selecting patients for genetic counseling in memory clinics.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!