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Five-year mortality rate for patients with diabetic hand gangrene who undergo upper extremity amputation

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Abstract
Objective: The aim of this study was to describe the characteristics of patientsundergoing upper extremity amputation (UEA) for diabetic hand gangrene with aspecial focus on mortality and to determine the risk factors for thedevelopment of hand gangrene in diabetic patients.

Methods: The medical records of patients who underwent lower extremity amputation (LEA) or UEA because of diabetic gangrene between January 2005 and December 2012 were retrospectively reviewed. Patients were then assigned to one of two groups: the UEA group (n = 15, 9 male; mean age = 62 +/- 12.4) and the LEA group (n = 280, 196 male; mean age = 64.6 +/- 10.9). A Kaplan-Meier analysis was performed to compare the five-year survival rates between the two groups. A multivariable logistic analysis including demographic characteristics, laboratory data, and dialysis status was conducted to identify the risk factors for diabetic hand gangrene.

Results: The five-year mortality rate in the UEA group (86.7%, 13 of 15 patients) was significantly higher than that in the LEA group (51.8%, 145 of 280 patients, P < 0.001). Dialysis status was determined as a risk factor associated with the development of diabetic hand gangrene (OR, 4.05; 95% CI, 1.23-13.29; P = 0.021).

Conclusion: Evidence from this study has revealed that that amputation for diabetichand gangrene is associated with a high rate of mortality. Among diabeticpatients, the five-year survival rate of patients who underwent amputation fordiabetic hand gangrene was only 13.3%.

Level of Evidence: Level IV, Prognostic Study.
Author(s)
김재광Shin Woo ChoiYoung Ho Shin
Issued Date
2021
Type
Article
Keyword
AgedAmputationDiabetes Mellitus* / epidemiologyDiabetic Angiopathies*Diabetic Foot*GangreneHandHumansLower ExtremityMaleMiddle AgedRetrospective StudiesRisk Factors
DOI
10.5152/j.aott.2021.21100
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8690
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_43817dad7fbe48bcb89682333b7c10ae&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Five-year%20mortality%20rate%20for%20patients%20with%20diabetic%20hand%20gangrene%20who%20undergo%20upper%20extremity%20amputation&amp;offset=0&amp;pcAvailability=true
Publisher
ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA
Location
터키
Language
영어
ISSN
1017-995X
Citation Volume
55
Citation Number
4
Citation Start Page
344
Citation End Page
348
Appears in Collections:
Medicine > Medicine
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