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Study notes risk factors of revision after amputation in patients with diabetes, PAD
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Results from a retrospective review showed an overall revision rate of 25.2% among patients with either peripheral arterial disease or diabetes who underwent lower extremity amputation, and indicated diabetic nephropathy and polyneuropathy as risk factors of revision.
Researchers identified 421 patients with either peripheral arterial disease or diabetes who underwent a lower extremity primary amputation. Investigators collected clinical data and demographics from institutional electronic medical records. Medical records also were used to determine the date of presence and type of diabetes, diagnosis, duration and treatment.
Data collected also included the level and type of amputation, whether the revision was performed at the same or proximal level, the time between the amputation and first revision, and the presence of polyneuropathy or diabetic nephropathy. Fontaine stages were used to grade peripheral arterial disease. Significant predictors for revision were determined with logistic regression.
Findings showed the revision rate overall was 25.2%. Mean time to revision following the initial amputation was 244 days. Investigators noted that revision amputation at a more proximal level was linked with type 1 or type 2 diabetes. Patients who underwent peripheral transluminal angioplasty or peripheral bypass surgery were significantly associated with revision surgery. Investigators found revision rates significantly increased with increasing Fontaine stage.
According to researchers, polyneuropathy and diabetic nephropathy were both risk factors for revision amputation. Patients who underwent revision amputation compared with those who did not had a significantly younger mean age of 65.23 years vs. 68.52 years. ‒ by Monica Jaramillo
Disclosure: The researchers report no relevant financial disclosures.
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