title: Retrospective study of the evolution of the incidence of non-traumatic lower-extremity amputations (2007-2013) and risk factors of reamputation.
abstract: Describe the incidence of non-traumatic amputation in a Spain region and identify the risk factors associated with the level of amputation and reamputation.
  
  
  
  Retrospective study on non-traumatic lower-extremity amputees in a Spanish region between 2007 and 2013. A descriptive, bivariate and multivariate analysis was performed using bivariate logistic regression. Statistical significance p≤0.05, SPSS V.21.
  
  
  
  495 amputations were carried out in 353 patients. 81.0% (n=286) were men, mean age 68.7±10.8 years. The most frequent levels of amputation were digital (45.9%) and above-knee (40.5%). About 30% of the patients were reamputated. The multivariate analysis revealed that the factors independently related to the need for a minor lower-extremity amputation were DM [OR 3.79 (CI 95% 2.0-7.27)], foot ulcer [OR 5.82 (CI 95% 2.24-15.11)] and previous ipsilateral amputation [OR 3.19 (CI 95% 1.21-8.42)]. The risk factors independently related to the need for reamputation were DM [OR 2.21 (CI95% 1.09-4.49)], smoking [OR 2.45 (CI95% 1.33-4.50)] and previous revascularization [OR 2.75 (CI95% 1.57-4.83)].
  
  
  
  Determining the incidence of amputations in diabetic patients as an indicator of quality makes it possible for health services to be evaluated. In patients with DM the most common reamputations are minor and ipsilateral.
authors.affiliation: Nursing Department, Universitat Rovira i Virgili, Tarragona, Spain. Electronic address: mariaisabel.font@urv.cat.
authors.forename: Isabel
authors.initials: I
authors.lastname: Font-Jiménez
authors.affiliation: Nursing Department, Universitat Rovira i Virgili, Tarragona, Spain. Electronic address: mireiallaurado@gmail.com.
authors.forename: Mireia
authors.initials: M
authors.lastname: Llaurado-Serra
authors.affiliation: University Hospital Joan XXIII de Tarragona, Tarragona, Spain. Electronic address: montseroig74@gmail.com.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Roig-Garcia
authors.affiliation: University Hospital Joan XXIII de Tarragona, Tarragona, Spain. Electronic address: belenmp88@gmail.com.
authors.forename: Belen
authors.initials: B
authors.lastname: De Los Mozos-Perez
authors.affiliation: Nursing Department, Universitat Rovira i Virgili, Tarragona, Spain. Electronic address: msagrario.acebedo@urv.cat.
authors.forename: Sagrario
authors.initials: S
authors.lastname: Acebedo-Urdiales
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000639:trends*; D017719:Diabetic Foot / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D015995:Prevalence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
keywords: Diabetes mellitus; Epidemiology; Foot ulcer; Non-traumatic amputation; Reamputation