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Lower Extremity Amputations Among Patients with Diabetes Mellitus: A Five-Year Analysis in a Clinical Hospital in Bucharest, Romania

Authors :
Emilia Rusu
Eduard Lucian Catrina
Iulian Brezean
Ana Maria Georgescu
Alexandra Vișinescu
Daniel Andrei Vlad Georgescu
Chivu Anda Mioara
Grațiela Maria Dobra
Ioana Verde
Silviu Stanciu
Andrada Coșoreanu
Florin Rusu
Andra Nica
Doina Andrada Mihai
Gabriela Radulian
Source :
Medicina, Vol 60, Iss 12, p 2001 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

Background and Objectives: Lower extremity amputations (LEAs) represent a significant health problem. The aim of our study was to analyse the type and trends of diabetes-related LEAs in patients hospitalized in one surgical centre in Bucharest between 2018 and 2021. The second aim was to assess the impact of the COVID-19 pandemic on the trends of LEAs. Materials and Methods: We performed a retrospective analysis of all lower limb amputations performed between 01 January 2018 and 31 December 2021 in the Department of Surgery, Dr. I. Cantacuzino Clinical Hospital, Bucharest, Romania. We evaluated demographic parameters, type of LEA, the level, the laterality and trends of the amputations, the main aetiologies leading to amputation, and the length of hospitalization. Results: During the study period, 1711 patients underwent an LEA. The mean age was 64.53 ± 9.93 years, 71.6% (n = 1481) being over 60. Men outnumbered women by a ratio of 3.62:1. The most frequent interventions were ray amputations in 41.2% (n = 705) of patients; then, there were amputations of the toe (20.4%, n = 349), transtibial amputations (18.9%, n = 323), transfemoral amputations (10.6%, n = 181), and midfoot amputations (9%, n = 154). Wet gangrene was the most frequent aetiology (40.9%, n = 699). The total number of LEAs decreased constantly throughout the analysed period, such that 616 LEAs were performed in 2018 and 323 LEAs in 2021 (p < 0.001). There was a statistically significant increase in the rate of major LEAs in the pandemic vs. pre-pandemic period (37% vs. 24.4%, p < 0.001). Conclusions: In our study, the total number of LEAs decreased throughout the analysed period, but there was an increase in the rate of major LEAs in the pandemic vs. pre-pandemic period. Being over 65 years of age, leucocytosis, sepsis at presentation, and diabetic polyneuropathy were important risk factors for the necessity of LEA in complicated diabetes-related foot disease.

Details

Language :
English
ISSN :
16489144 and 1010660X
Volume :
60
Issue :
12
Database :
Directory of Open Access Journals
Journal :
Medicina
Publication Type :
Academic Journal
Accession number :
edsdoj.b7abd8bf52b14a888ad4ae10ce28a79e
Document Type :
article
Full Text :
https://doi.org/10.3390/medicina60122001