Fewer Major Amputations Among Individuals With Diabetes in Finland in 1997-2007 A population-based study

被引:78
作者
Ikonen, Tuija S. [1 ]
Sund, Reijo [1 ]
Venermo, Maarit [2 ]
Winell, Klas [1 ]
机构
[1] THL Natl Inst Hlth & Welf, Helsinki, Finland
[2] Hosp Dist Helsinki & Uusimaa, Helsinki, Finland
关键词
LOWER-LIMB AMPUTATIONS; LOWER-EXTREMITY AMPUTATIONS; MORTALITY; REDUCTION; RATES;
D O I
10.2337/dc10-0462
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - Complications occur in diabetes despite rigorous efforts to control risk factors Since 2000 the National Development Programme for the Prevention and Care of Diabetes has worked to halve the incidence of amputations in 10 years Here we evaluate the impact of the efforts undertaken by analyzing the major amputations done in 1997-2007 RESEARCH DESIGN AND METHODS - All individuals with diabetes (n = 396 317) were identified from comprehensive national databases Data on the first major amputations (n = 9 481) performed for diabetic and nondiabetic individuals were obtained from the National Hospital Discharge Register RESULTS - The relative risk for the first major amputation was 7 4(95% CI 7 2-7 7) among the diabetic versus the nondiabetic population The standardized incidence of the first major amputation decreased among the diabetic and nondiabetic populations (48 8 and 25 2% relative risk reduction respectively) over 11 years, and the time from the registration of diabetes to the first major amputation was significantly longer on average 1 2 years more The cumulative five-year postamputation mortality among diabetic individuals was 78 7% CONCLUSIONS - In our nationwide diabetes database the duration from the registration of diabetes to the first major amputation increased and the incidence of major amputations decreased almost 50% in 11 years Approximately half of this change was due to the increasing size of the diabetic population The risk for major amputation is more than sevenfold that among the nondiabetic population These results pose a continuous challenge to improve diabetes care
引用
收藏
页码:2598 / 2603
页数:6
相关论文
共 25 条
[1]  
[Anonymous], 2009, REGISTER BASED MEASU
[2]  
[Anonymous], 2004, TOIMENPIDELUOKITUS H, V2
[3]  
[Anonymous], 1986, TOIMENPIDENIMIKKEIST
[4]   Reducing the incidence of foot ulceration and amputation in diabetes [J].
Bartus C.L. ;
Margolis D.J. .
Current Diabetes Reports, 2004, 4 (6) :413-418
[5]   Diabetes- and nondiabetes-related lower extremity amputation incidence before and after the introduction of better organized diabetes foot care - Continuous longitudinal monitoring using a standard method [J].
Canavan, Ronan J. ;
Unwin, Nigel C. ;
Kelly, William F. ;
Connolly, Vincent M. .
DIABETES CARE, 2008, 31 (03) :459-463
[6]   Major amputation incidence decreases both in non-diabetic and in diabetic patients in Helsinki [J].
Eskelinen, E. ;
Eskelinen, A. ;
Alback, A. ;
Lepantalo, M. .
SCANDINAVIAN JOURNAL OF SURGERY, 2006, 95 (03) :185-189
[7]   Lower limb amputations in Southern Finland in 2000 and trends up to 2001 [J].
Eskelinen, E ;
Lepäntalo, M ;
Hietala, EM ;
Sell, H ;
Kauppila, L ;
Mäenpää, I ;
Pitkänen, J ;
Salminen-Peltola, P ;
Leutola, S ;
Eskelinen, A ;
Kivioja, A ;
Tukiainen, E ;
Lukinmaa, A ;
Brasken, P ;
Railo, M .
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2004, 27 (02) :193-200
[8]  
*FINN DIAB ASS, 2009, DEV PROGR PREV CAR D
[9]   All-Cause Mortality After Diabetes-Related Amputation in Barbados A prospective case-control study [J].
Hambleton, Ian R. ;
Jonnalagadda, Ramesh ;
Davis, Christopher R. ;
Fraser, Henry S. ;
Chaturvedi, Nish ;
Hennis, Anselm J. .
DIABETES CARE, 2009, 32 (02) :306-307
[10]   Lower limb amputations: Differences between the genders and long-term survival [J].
Heikkinen, M. ;
Saarinen, J. ;
Suominen, V. P. ;
Virkkunen, J. ;
Salenius, J. .
PROSTHETICS AND ORTHOTICS INTERNATIONAL, 2007, 31 (03) :277-286