While amputations are associated with reduced long-term survival in patients with diabetic foot disease, there is little long-term survival data in published literature, according to a report published online in the journal Endocrine. The report’s authors combed through the electronic case records and laboratory details of patients who underwent amputations between 1997 and 2006 to obtain at least ten years of follow-up data after the surgery to assess the survival rates and possible risk factors reducing survival in the year 2016. Amputation level below ankle was considered as minor and above ankle as major amputations.
The authors concluded that five-year and ten-year survival rates were 40 percent and 24 percent, respectively, following diabetic foot amputations. Patients older than age 70 years had a lower survival rate compared with younger age groups after lower extremity amputations.
Results of the report showed that of the 233 cases (159 men; median age 68 years), 161 had major amputations. Of the 72 cases who had minor amputations initially, 63 needed a further amputation or contralateral amputation on follow up. A total of 177 patients (76 percent) were not alive after ten years of follow up.
The survival rates at one, three, five, seven, and greater than ten years, were 64 percent, 50 percent, 40 percent, 34 percent, and 24 percent, respectively. Maximum number of deaths occurred within four months of amputations, according to the report, and there was no difference between survival rates following major or minor amputations and among men or women.
The report found that the only statistically significant parameter affecting lower survival rate was being more than 70 years old, with each additional year of age increasing the hazard by a factor of 1.039 or 3.9 percent.
