Minor vs. major leg amputation in adults with diabetes: Six-month readmissions, reamputations, and complications

Hunter T. Ratliff, Naohiro Shibuya, Daniel C. Jupiter

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: The objective of this study was comparing medium-term outcomes between comparable minor and major amputations in adults with diabetes. Methods: We used data from the 2016–2017 National Readmissions Database to construct a representative cohort of 15,581 adults with diabetes with lower extremity amputations. Patients were categorized by level of index amputation (major/minor), and propensity score matched to compare outcomes in candidates for either level of amputation. Readmission and reamputations were assessed at 1, 3, and 6 months following index amputation. Results: In the 6 months following index amputation, large proportions of patients were readmitted (n = 7597, 48.8%) or had reamputations (n = 1990, 12.8%). Patients with minor amputations had greater odds of readmission (OR = 1.25; 95% CI 1.18–1.31), reamputation (OR = 3.71; 95% CI 3.34–4.12), and more proximal reamputation (OR = 2.61; 95% 2.33–2.93) (all P < 0.001). Further, minor amputation patients had higher and lower odds of readmission for postoperative infection (OR = 4.45; 95% CI 3.27–6.05), or sepsis (OR = 0.79; 95% CI 0.68–0.93), respectively. Conclusion: Patients desire to save as much limb as possible and should be counseled on higher risk for reamputation, readmission, and infection with minor amputations.

Original languageEnglish (US)
Article number107886
JournalJournal of Diabetes and Its Complications
DOIs
StateAccepted/In press - 2021

Keywords

  • Amputation of lower limb
  • Diabetes mellitus
  • Diabetic foot
  • Infection
  • Readmission

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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