Diabetes and vulnerabilities in people undergoing lower-extremity amputation

INTRODUCTION. Knowledge of the characteristics of those who undergo major lower-extremity amputation (LEA) in Denmark is lacking. In this study, we described socioeconomic and demographic factors, comorbidity, healthcare contacts and mortality in people who underwent major LEA.

METHODS. This was a descriptive observational study. We identified first non-traumatic major LEAs (2019-2021) in the National Patient Registry and classified people by diabetes status. We matched the LEA population to people from the general population based on age, sex, calendar quarter and diabetes status and linked data on socioeconomic and demographic factors, comorbidity, healthcare contacts and mortality from national administrative registries

RESULTS. The LEA population constituted 3,088 people (no diabetes: N = 1,722, 55.8%; type 1 diabetes: 153, 5.0%; type 2 diabetes: N = 1,213, 39.3%). Compared to the reference group, a higher proportion of the LEA population were single, had basic education, were in a low-income group and resided in a non-urban municipality. The LEA population had many healthcare contacts leading up to their major LEA, and a very high proportion had comorbidities, most notably cardiovascular disease (85.1%). Lastly, 30-day and one-year mortality were 15.8% and 29.3%, respectively.

CONCLUSIONS. About two in five who underwent major LEA had diabetes. We found marked social inequality, higher comorbidity, higher mortality and more healthcare contacts in the LEA population than in the reference group.

FUNDING. None.

TRIAL REGISTRATION. Not relevant.