Claessen, Heiner, Narres, Maria, Haastert, Burkhard, Arend, Werner, Hoffmann, Falk ORCID: 0000-0003-0182-5373, Morbach, Stephan, Ruemenapf, Gerhard, Kvitkina, Tatjana, Friedel, Heiko, Guenster, Christian, Schubert, Ingrid, Ullrich, Walter, Westerhoff, Benjamin, Wilk, Adrian and Icks, Andrea (2018). Lower-extremity amputations in people with and without diabetes in Germany, 2008-2012-an analysis of more than 30 million inhabitants. Clin. Epidemiol., 10. S. 475 - 489. ALBANY: DOVE MEDICAL PRESS LTD. ISSN 1179-1349

Full text not available from this repository.

Abstract

Background and purpose: Lower-extremity amputations (LEAs) in people with diabetes are associated with reduced quality of life and increased health care costs. Detailed knowledge on amputation rates (ARs) is of utmost importance for future health care and economics strategies. We conducted the present cohort study in order to estimate the incidences of LEA as well as relative and attributable risk due to diabetes and to investigate time trends for the period 2008-2012. Methods: On the basis of the administrative data from three large branches of German statutory health insurers, covering similar to 34 million insured people nationwide (about 40% of the German population), we estimated age-sex-standardized AR (first amputation per year) in the populations with and without diabetes for any, major, and minor LEAs. Time trends were analyzed using Poisson regression. Results: A total of 108,208 individuals (diabetes: 67.3%; mean age 72.6 years) had at least one amputation. Among people with diabetes, we observed a significant reduction in major and minor ARs during 2008-2012 from 81.2 (95% CI 77.5-84.9) to 58.4 (55.0-61.7), and from 206.1 (197.3-214.8) to 177.0 (169.7-184.4) per 100,000 person-years, respectively. Among people without diabetes, the major AR decreased significantly from 14.3 (13.9-14.8) to 11.6 ([11.2-12.0], 12.0), whereas the minor AR increased from 15.8 (15.3-16.3) to 17.0 (16.5-17.5) per 100,000 person-years. The relative risk (RR) comparing the diabetic with the nondiabetic populations decreased significantly for both major and minor LEAs (4% and 5% annual reduction, respectively). Conclusion: In this large nationwide population, we still found higher major and minor ARs among people with diabetes compared with those without diabetes. However, AR and RR of major and minor LEAs in the diabetic compared with the nondiabetic population decreased significantly during the study period, confirming a positive trend that has been observed in smaller and regional studies in recent years.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Claessen, HeinerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Narres, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haastert, BurkhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arend, WernerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoffmann, FalkUNSPECIFIEDorcid.org/0000-0003-0182-5373UNSPECIFIED
Morbach, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruemenapf, GerhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kvitkina, TatjanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Friedel, HeikoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guenster, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schubert, IngridUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ullrich, WalterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Westerhoff, BenjaminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wilk, AdrianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Icks, AndreaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-202967
DOI: 10.2147/CLEP.S146484
Journal or Publication Title: Clin. Epidemiol.
Volume: 10
Page Range: S. 475 - 489
Date: 2018
Publisher: DOVE MEDICAL PRESS LTD
Place of Publication: ALBANY
ISSN: 1179-1349
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
LOWER-LIMB AMPUTATIONS; QUALITY-OF-LIFE; FOOT ULCERATION; HEALTH; POPULATION; MELLITUS; INDIVIDUALS; PREVALENCE; DISEASE; GENDERMultiple languages
Public, Environmental & Occupational HealthMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/20296

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item