title: Comparison of mortality rates and functional results after transtibial and transfemoral amputations due to diabetes in elderly patients-a retrospective study.
abstract: BACKGROUND
  This study aimed to compare mortality rates and functional results of transtibial and transfemoral amputations in elderly patients with diabetes.
  
  
  METHODS
  87 amputees [54 (62.1%) transtibial and 33 (37.9%) transfemoral] were included. Mean ages were 70.7 and 69.3 years in transfemoral and transtibial groups, respectively. Mean follow up time was 41.8 months. Amputee Mobility Predictor scores (with and without prosthesis) and Barthel Daily Living Index were used for functional evaluation of the survivors.
  
  
  RESULTS
  First year mortality rates were 29.6% and 30.3% in transtibial and transfemoral groups, respectively. Overall mortality rate of both groups was 65.5% (66.7% in transtibial and 63.6% in transfemoral group). There was no difference between mortality rates of two groups. Duration between surgery and death was significantly shorter in transfemoral group. The mean Amputee Mobility Predictor scores (with prosthesis) of the transtibial and transfemoral groups were 32.3 and 26.9 points, respectively. The average Amputee Mobility Predictor scores (without prosthesis) of the transtibial and transfemoral groups were 29.5 and 22.7 points respectively. The differences between two groups' scores were significant. The mean Barthel Daily Living Index scores of the transtibial and transfemoral groups were 82.5 and 80.2 points respectively. The difference was not significant.
  
  
  CONCLUSIONS
  High mortality rates and morbidities after major lower limb amputations emphasize the importance of preventive measures and foot care in patients with diabetes.
authors.affiliation: Istanbul Medipol University, Department of Orthopaedics and Traumatology, Istanbul, Turkey. Electronic address: aliseker@doctor.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Seker
authors.affiliation: Istanbul Medipol University, Department of Orthopaedics and Traumatology, Istanbul, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kara
authors.affiliation: Sisli Etfal Training and Research Hospital Orthopaedics and Traumatology Clinic, Istanbul, Turkey.
authors.forename: Savas
authors.initials: S
authors.lastname: Camur
authors.affiliation: Istanbul Medipol University, Department of Orthopaedics and Traumatology, Istanbul, Turkey.
authors.forename: Melih
authors.initials: M
authors.lastname: Malkoc
authors.affiliation: Sisli Etfal Training and Research Hospital Orthopaedics and Traumatology Clinic, Istanbul, Turkey.
authors.forename: Mehmet Mesut
authors.initials: MM
authors.lastname: Sonmez
authors.affiliation: Istanbul Medipol University, Department of Orthopaedics and Traumatology, Istanbul, Turkey.
authors.forename: Mahir
authors.initials: M
authors.lastname: Mahirogullari
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001186:Artificial Limbs; D003925:Diabetic Angiopathies / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005269:Femur; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D015996:Survival Rate; D013977:Tibia
keywords: Amputation; Diabetes; Functional results; Mortality; Transfemoral; Transtibial