Trends of Non-Traumatic Lower-Extremity Amputation and Type 2 Diabetes: Spain, 2001–2019

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dc.contributor.authorLópez de Andrés, Ana
dc.contributor.authorJiménez García, Rodrigo
dc.contributor.authorHernández Barrera, Valentín
dc.contributor.authorMiguel Díez, Javier de
dc.contributor.authorMiguel Yanes, Jose M. de
dc.contributor.authorOmaña Palanco, Ricardo
dc.contributor.authorCarabantes Alarcón, David
dc.date.accessioned2023-06-22T10:46:27Z
dc.date.available2023-06-22T10:46:27Z
dc.date.issued2022-02-25
dc.description.abstract(1) Background: To examine trends in the incidence (2001–2019), clinical characteristics and in-hospital outcomes following major and minor non-traumatic lower-extremity amputations (LEAs) among people with type 2 diabetes mellitus (T2DM) in Spain, assessing possible sex differences. (2) Methods: Retrospective cohort study using data from the Spanish National Hospital Discharge Database. Joinpoint regression was used to estimate incidence trends, and multivariable logistic regression to estimate factors associated with in-hospital mortality (IHM). (3) Results: LEA was coded in 129,059 patients with T2DM (27.16% in women). Minor LEAs accounted for 59.72% of amputations, and major LEAs comprised 40.28%. The adjusted incidences of minor and major LEAs were higher in men than in women (IRR 3.51; 95%CI 3.46–3.57 and IRR 1.98; 95%CI 1.94–2.01, respectively). In women, joinpoint regression showed that age-adjusted incidence of minor LEAs remained stable over time, and for major LEAs, it decreased from 2006 to 2019. In men, incidences of minor and major LEAs decreased significantly from 2004 to 2019. In-hospital mortality (IHM) increased with age and the presence of comorbidity, such as heart failure (OR 5.11; 95%CI 4.61–5.68, for minor LEAs and OR 2.91; 95%CI 2.71–3.13 for major LEAs). Being a woman was associated with higher IHM after minor and major LEA (OR 1.3; 95%CI 1.17–1.44 and OR 1.18; 95%CI 1.11–1.26, respectively). (4) Conclusions: Our data showed major sex differences indicating decreasing and increasing LEA trends among men and women, respectively; furthermore, women presented significantly higher IHM after minor and major LEA procedures than men.
dc.description.departmentDepto. de Salud Pública y Materno - Infantil
dc.description.facultyFac. de Medicina
dc.description.refereedTRUE
dc.description.sponsorshipInstituto de Salud Carlos III (ISCIII)/FEDER
dc.description.sponsorshipUniversidad Complutense de Madrid
dc.description.statuspub
dc.eprint.idhttps://eprints.ucm.es/id/eprint/72867
dc.identifier.doi10.3390/jcm11051246
dc.identifier.issn2077-0383
dc.identifier.officialurlhttps://doi.org/10.3390/jcm11051246
dc.identifier.relatedurlhttps://www.mdpi.com/2077-0383/11/5/1246/htm
dc.identifier.urihttps://hdl.handle.net/20.500.14352/71637
dc.issue.number5
dc.journal.titleJournal of Clinical Medicine
dc.language.isoeng
dc.page.initial1246
dc.publisherMPDI
dc.relation.projectID(PI20/00118)
dc.relation.projectID(970970)
dc.rightsAtribución 3.0 España
dc.rights.accessRightsopen access
dc.rights.urihttps://creativecommons.org/licenses/by/3.0/es/
dc.subject.keywordamputation: lower extremity
dc.subject.keyworddiabetes
dc.subject.keywordhospitalization
dc.subject.keywordmortality
dc.subject.keywordsex differences
dc.subject.ucmEndocrinología
dc.subject.unesco3205.02 Endocrinología
dc.titleTrends of Non-Traumatic Lower-Extremity Amputation and Type 2 Diabetes: Spain, 2001–2019
dc.typejournal article
dc.volume.number11
dspace.entity.typePublication
relation.isAuthorOfPublication5db1f21a-0369-4191-96f5-b640ed0f3dde
relation.isAuthorOfPublication0805925a-30d0-428b-a341-09cf7facbac3
relation.isAuthorOfPublication0de35c8b-4b4c-4920-9225-94e4cf4dfb1f
relation.isAuthorOfPublication.latestForDiscovery5db1f21a-0369-4191-96f5-b640ed0f3dde
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