title: Postoperative outcomes of major lower extremity amputations in patients with diabetes and peripheral artery disease: analysis using the Diagnosis Procedure Combination database in Japan.
abstract: BACKGROUND
  The purpose of the present study was to investigate 30-day postoperative outcomes after lower extremity amputation in patients with diabetes mellitus (DM) alone, peripheral artery disease (PAD) alone, or both.
  
  
  METHODS
  Eight thousand five hundred sixty-five patients with DM alone (n = 2,700), PAD alone (n = 2,919), and both (n = 2,946) who had above-knee amputation or below-knee amputation during 2007 to 2012 from the Japanese Diagnosis Procedure Combination inpatient database were retrospectively analyzed.
  
  
  RESULTS
  Overall 30-day mortality was 6.4% (5.1%, 8.5%, and 5.6% in DM alone, PAD alone and both group, respectively). Multivariable regression analysis showed no significant differences in 30-day mortality or overall postoperative complication rates among the 3 groups. Patients with both PAD and DM had a significantly higher proportion of cardiac events than those with DM alone (6.9% vs 3.0%; odds ratio = 2.27; 95% confidence interval = 1.73 to 2.98).
  
  
  CONCLUSIONS
  Patients with both DM and PAD were more likely to have postoperative cardiac events.
authors.affiliation: Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan. Electronic address: yasunagah-tky@umin.ac.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
authors.affiliation: Faculty of Medicine, Department of Sensory & Motor System Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Yuho
authors.initials: Y
authors.lastname: Kadono
authors.affiliation: Faculty of Medicine, Department of Sensory & Motor System Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Chikuda
authors.affiliation: Department of Rehabilitation for Movement Functions, National Rehabilitation Center for Persons with Disabilities, Research Institute, Saitama, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ogata
authors.affiliation: Department of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, Tokyo, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Horiguchi
authors.affiliation: Faculty of Medicine, Department of Sensory & Motor System Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Sakae
authors.initials: S
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D035002:Lower Extremity / Q000098:blood supply* / Q000601:surgery; D008297:Male; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
keywords: Cardiac events; Diabetes mellitus; Lower extremity amputation; Mortality; Peripheral artery disease