Major amputations in type 2 diabetes between 2001 and 2015 in Spain: regional differences

Major amputations in type 2 diabetes between 2001 and 2015 in Spain: regional differences

To analyze the trend of lower extremity major amputations (MA) among patients with type 2 diabetes mellitus (T2DM) in the Regions of Spain from year 2001 until 2015. Descriptive study of 40,392 MA. Data were obtained from the national hospital discharge database in patients with T2DM. The incidence...

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Bibliographic Details
Published in:BMC public health Vol. 20; no. 1; p. 54
Main Authors: Rodríguez Pérez, María Del Cristo, Chines, Chiara, Pedrero García, Arturo J, Sousa, Djeniffer, Cuevas Fernández, Francisco J, Marcelino-Rodríguez, Itahisa, Domínguez Coello, Santiago, Cabrera de León, Antonio
Format: Journal Article
Language:English
Published: England BioMed Central Ltd 14-01-2020
BioMed Central
BMC
Subjects:
Age
Aged
Aged, 80 and over
Amputation
Amputation - statistics & numerical data
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - epidemiology
Female
Health risks
Hospital admission and discharge
Hospital stay
Hospital stays
Humans
Incidence
Islands
Lower Extremity - surgery
Major amputation
Male
Middle Aged
Mortality
Mortality risk
Patients
Public health
Regional analysis
Regional differences
Regression analysis
Regression models
Retrospective Studies
Smoking
Spain - epidemiology
Statistics
Type 2 diabetes
Spain
Canary Islands
Type 2 diabetes
Major amputation
Mortality
Hospital stay
Incidence
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Summary:To analyze the trend of lower extremity major amputations (MA) among patients with type 2 diabetes mellitus (T2DM) in the Regions of Spain from year 2001 until 2015. Descriptive study of 40,392 MA. Data were obtained from the national hospital discharge database in patients with T2DM. The incidence rate was calculated in each Region, in addition to the incidence ratios (IR) between annual incidence and incidence of the year 2001. The length of hospital stay and mortality risks were analyzed using regression models adjusted for sex, age and smoking. The major amputations incidence rate per 100,000 person-years was 0.48 in Spain; Canary Islands showed the highest incidence (0.81). The trend was a slight decrease or stability of the incidence in all Regions except in the Canary Islands (IR  = 2.0 [CI95% = 1.5, 2.6]) and in Madrid (IR  = 0.1 [CI95% = 0.1, 0.2]). Mortality after major amputations was 10% in Spain; Cantabria suffered the highest risk of death [1.7 (CI95% = 1.4; 2.1), p < 0.001] and La Rioja the lowest risk (0.5 [CI95% = 0.2; 0.9]; p = 0.026). The longest hospital stay was registered in the Canary Islands [(CI95% = 11.4;13.3], p < 0.001)], and the shortest in the Valencian Community [(CI95% = - 7.3; - 5.8), p < 0.001)]. MA in T2DM followed a growing trend in the Canary Islands, which diverged from the downward trend in Spain. The variability of mortality and hospital stay, suggest to review the clinical management in some Regions. Sudden incidence decrease in Madrid suggests checking the record procedures of hospital discharges.
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ISSN:1471-2458
1471-2458
DOI:10.1186/s12889-019-8137-7