Diabetes ups risk of amputation in critical limb ischemia
(HealthDay)—For patients with critical limb ischemia (CLI), those with diabetes mellitus (DM) are at increased risk of major amputation, according to a study published online Sept. 9 in Diabetes Care.
Marlon I. Spreen, M.D., from Haga Teaching Hospital in The Hague, Netherlands, and colleagues examined the implications of DM in a population of patients with infrapopliteal CLI. Individual data from patients with CLI were pooled. The rates of major amputation and major events (major amputation or death) were compared for CLI patients with and without DM.
The researchers found that 49.1 percent of the 281 patients had DM. At five-years of follow-up the rate of major amputation was higher in patients with versus without DM (34.1 versus 20.4 percent; P = 0.015). There was no difference in the major event and death rate. For major amputation risk, the unadjusted hazard ratio of DM was 1.87. In multivariate analysis, factors with significant hazard ratios were baseline Rutherford category (hazard ratio, 1.95) and ankle-brachial index >1.4 (hazard ratio, 2.78).
"CLI patients with DM are at a significantly higher risk of major amputation than CLI patients without DM," the authors write.
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