title: In-hospital mortality and disposition of diabetic amputees in The Netherlands.
abstract: The purpose of this study is to identify in-hospital mortality of diabetic amputees and the disposition of survivors in The Netherlands in 1991 and 1992. A database including all hospitalizations in The Netherlands was used. Amputees who died while in the hospital were analysed separately. Survivors were categorized according to different types of discharge: home, nursing home, rehabilitation facility, and other health care facilities. Overall 9.0% of diabetic amputees died while in hospital. The age-adjusted mortality incidence for the diabetic population was 36.3 per 1000 diabetic amputees (95% CI: 18.7-53.9) and 28.2 per 1,000 non-diabetic amputees (95% CI: 20.5-35.9). Non-diabetic amputees with PVD has proportionally more mortality than diabetic amputees with PVD (P < 0.01), diabetic amputees without PVD (P < 0.01), and non-diabetic amputees without PVD (P < 0.001). Using Cox regression analysis age (B(age) = 0.023, RR = 1.024) and the occurrence of multiple amputations during the hospitalization (Bmultiple = 0.325, RR = 1.383) were significant negative predictors for survival. As age and level of amputation increased, more diabetic and non-diabetic amputees were discharged to facilities other than home (P < 0.001).
authors.affiliation: Mexican-American Medical Treatment Effectiveness Research Center, University of Texas Health Science Center at San Antonio, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Lavery
authors.forename: W H
authors.initials: WH
authors.lastname: van Houtum
authors.forename: L B
authors.initials: LB
authors.lastname: Harkless
mesh_terms: D000367:Age Factors; D000368:Aged; D000671:Amputation, Surgical; D017719:Diabetic Foot / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010351:Patient Discharge; D016491:Peripheral Vascular Diseases / Q000150:complications; D012189:Retrospective Studies; D015996:Survival Rate