The amputation and mortality rates of diabetic patients with critical limb ischemia: A nationwide population-based follow-up study in Taiwan

Kuo Chun Liao, Shih Feng Weng, Chung Hsi Hsing, Cheng Liu, Jhi Joung Wang, Kuo Feng Huang, Chin Chen Chu

Research output: Contribution to journalArticle

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Abstract

Purpose: To describe the epidemiological profiles and the amputation and mortality rates of diabetic patients in Taiwan with critical limb ischemia. Materials and methods: Data were collected from the Longitudinal Health Insurance Database 2000 (LHID2000), a database composed of one million randomly selected beneficiaries in Taiwan. To measure major amputation and mortality, diabetic patients with critical limb ischemia (CLI) were identified by specific ICD-9-CM diagnostic, procedure, and order codes. The patients were traced until the end of 2009. Cox proportional hazard regressions were used to determine the crude and adjusted hazard ratios for the risk factors for amputation and mortality during the follow-up period. Results: We identified 6418 diabetic patients with CLI from the LHID database during 1997e2006. Of these patients, 256 (3.99%) patients underwent surgical revascularization and 6418 (96.01%) patients received conservative treatment only. The revascularization cohort had more comorbidities than the surgical group (e.g., cardiovascular, 13.28% vs. 8.62%, respectively, p Z 0.0099; renal, 23.05% vs. 5.34%, respectively, p <0.0001). The amputation and mortality rates for diabetic CLI patients in Taiwan were 5.75% and 18.62%, respectively. Male gender, an age of greater than 50 years old, and cardiovascular and renal comorbidities were identified as risk factors for amputation. The risk factors for mortality also included old age (i.e., >50 years), male gender, and comorbid cardiovascular, renal, neurological, and pulmonary diseases. Conclusion: Diabetic patients who needed surgical revascularization or who needed conservative treatment for CLI had different comorbid profiles. The common risk factors for amputation and mortality in diabetic CLI patients include male gender, age of > 50 years, and concurrent cardiovascular and renal diseases.

Original languageEnglish
Pages (from-to)79-86
Number of pages8
JournalFormosan Journal of Surgery
Volume46
Issue number3
DOIs
Publication statusPublished - Jun 2013

Fingerprint

Taiwan
Amputation
Ischemia
Extremities
Mortality
Population
Databases
Kidney
International Classification of Diseases
Health Insurance
Lung Diseases
Comorbidity
Cardiovascular Diseases

Keywords

  • Amputation
  • Critical limb ischemia
  • Diabetes
  • Revascularization

ASJC Scopus subject areas

  • Surgery

Cite this

The amputation and mortality rates of diabetic patients with critical limb ischemia : A nationwide population-based follow-up study in Taiwan. / Liao, Kuo Chun; Weng, Shih Feng; Hsing, Chung Hsi; Liu, Cheng; Wang, Jhi Joung; Huang, Kuo Feng; Chu, Chin Chen.

In: Formosan Journal of Surgery, Vol. 46, No. 3, 06.2013, p. 79-86.

Research output: Contribution to journalArticle

Liao, Kuo Chun ; Weng, Shih Feng ; Hsing, Chung Hsi ; Liu, Cheng ; Wang, Jhi Joung ; Huang, Kuo Feng ; Chu, Chin Chen. / The amputation and mortality rates of diabetic patients with critical limb ischemia : A nationwide population-based follow-up study in Taiwan. In: Formosan Journal of Surgery. 2013 ; Vol. 46, No. 3. pp. 79-86.
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abstract = "Purpose: To describe the epidemiological profiles and the amputation and mortality rates of diabetic patients in Taiwan with critical limb ischemia. Materials and methods: Data were collected from the Longitudinal Health Insurance Database 2000 (LHID2000), a database composed of one million randomly selected beneficiaries in Taiwan. To measure major amputation and mortality, diabetic patients with critical limb ischemia (CLI) were identified by specific ICD-9-CM diagnostic, procedure, and order codes. The patients were traced until the end of 2009. Cox proportional hazard regressions were used to determine the crude and adjusted hazard ratios for the risk factors for amputation and mortality during the follow-up period. Results: We identified 6418 diabetic patients with CLI from the LHID database during 1997e2006. Of these patients, 256 (3.99{\%}) patients underwent surgical revascularization and 6418 (96.01{\%}) patients received conservative treatment only. The revascularization cohort had more comorbidities than the surgical group (e.g., cardiovascular, 13.28{\%} vs. 8.62{\%}, respectively, p Z 0.0099; renal, 23.05{\%} vs. 5.34{\%}, respectively, p <0.0001). The amputation and mortality rates for diabetic CLI patients in Taiwan were 5.75{\%} and 18.62{\%}, respectively. Male gender, an age of greater than 50 years old, and cardiovascular and renal comorbidities were identified as risk factors for amputation. The risk factors for mortality also included old age (i.e., >50 years), male gender, and comorbid cardiovascular, renal, neurological, and pulmonary diseases. Conclusion: Diabetic patients who needed surgical revascularization or who needed conservative treatment for CLI had different comorbid profiles. The common risk factors for amputation and mortality in diabetic CLI patients include male gender, age of > 50 years, and concurrent cardiovascular and renal diseases.",
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T1 - The amputation and mortality rates of diabetic patients with critical limb ischemia

T2 - A nationwide population-based follow-up study in Taiwan

AU - Liao, Kuo Chun

AU - Weng, Shih Feng

AU - Hsing, Chung Hsi

AU - Liu, Cheng

AU - Wang, Jhi Joung

AU - Huang, Kuo Feng

AU - Chu, Chin Chen

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N2 - Purpose: To describe the epidemiological profiles and the amputation and mortality rates of diabetic patients in Taiwan with critical limb ischemia. Materials and methods: Data were collected from the Longitudinal Health Insurance Database 2000 (LHID2000), a database composed of one million randomly selected beneficiaries in Taiwan. To measure major amputation and mortality, diabetic patients with critical limb ischemia (CLI) were identified by specific ICD-9-CM diagnostic, procedure, and order codes. The patients were traced until the end of 2009. Cox proportional hazard regressions were used to determine the crude and adjusted hazard ratios for the risk factors for amputation and mortality during the follow-up period. Results: We identified 6418 diabetic patients with CLI from the LHID database during 1997e2006. Of these patients, 256 (3.99%) patients underwent surgical revascularization and 6418 (96.01%) patients received conservative treatment only. The revascularization cohort had more comorbidities than the surgical group (e.g., cardiovascular, 13.28% vs. 8.62%, respectively, p Z 0.0099; renal, 23.05% vs. 5.34%, respectively, p <0.0001). The amputation and mortality rates for diabetic CLI patients in Taiwan were 5.75% and 18.62%, respectively. Male gender, an age of greater than 50 years old, and cardiovascular and renal comorbidities were identified as risk factors for amputation. The risk factors for mortality also included old age (i.e., >50 years), male gender, and comorbid cardiovascular, renal, neurological, and pulmonary diseases. Conclusion: Diabetic patients who needed surgical revascularization or who needed conservative treatment for CLI had different comorbid profiles. The common risk factors for amputation and mortality in diabetic CLI patients include male gender, age of > 50 years, and concurrent cardiovascular and renal diseases.

AB - Purpose: To describe the epidemiological profiles and the amputation and mortality rates of diabetic patients in Taiwan with critical limb ischemia. Materials and methods: Data were collected from the Longitudinal Health Insurance Database 2000 (LHID2000), a database composed of one million randomly selected beneficiaries in Taiwan. To measure major amputation and mortality, diabetic patients with critical limb ischemia (CLI) were identified by specific ICD-9-CM diagnostic, procedure, and order codes. The patients were traced until the end of 2009. Cox proportional hazard regressions were used to determine the crude and adjusted hazard ratios for the risk factors for amputation and mortality during the follow-up period. Results: We identified 6418 diabetic patients with CLI from the LHID database during 1997e2006. Of these patients, 256 (3.99%) patients underwent surgical revascularization and 6418 (96.01%) patients received conservative treatment only. The revascularization cohort had more comorbidities than the surgical group (e.g., cardiovascular, 13.28% vs. 8.62%, respectively, p Z 0.0099; renal, 23.05% vs. 5.34%, respectively, p <0.0001). The amputation and mortality rates for diabetic CLI patients in Taiwan were 5.75% and 18.62%, respectively. Male gender, an age of greater than 50 years old, and cardiovascular and renal comorbidities were identified as risk factors for amputation. The risk factors for mortality also included old age (i.e., >50 years), male gender, and comorbid cardiovascular, renal, neurological, and pulmonary diseases. Conclusion: Diabetic patients who needed surgical revascularization or who needed conservative treatment for CLI had different comorbid profiles. The common risk factors for amputation and mortality in diabetic CLI patients include male gender, age of > 50 years, and concurrent cardiovascular and renal diseases.

KW - Amputation

KW - Critical limb ischemia

KW - Diabetes

KW - Revascularization

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