Incidence of Lower-limb Amputations in the Diabetic Compared to the Non-diabetic Population. Findings from Nationwide Insurance Data, Germany, 2005-2007
Incidence of Lower-limb Amputations in the Diabetic Compared to the Non-diabetic Population. Findings from Nationwide Insurance Data, Germany, 2005-2007
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DOI：
10.1055/s-0029-1225333
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发表时间：
2009-10-01
影响因子：
1.8
通讯作者：
Hoffmann, F.
中科院分区：
文献类型：
--
作者：
Icks, A.;Haastert, B.;Hoffmann, F.
引言：一个主要目的是降低糖尿病下肢截肢的风险。全国范围内的数据截肢的发病率在糖尿病和非糖尿病人群在德国以及相对和归因于糖尿病的风险是缺乏迄今为止，材料和方法：使用数据的全国性法定健康保险（160万成员），我们评估了所有的第一次非创伤性下肢截肢2005年至2007年之间。我们估计的性别年龄特异性和标准化的发病率截肢的糖尿病和非糖尿病人群，相对和归因于糖尿病的风险。结果：所有受试者的第一次截肢在研究期间2005-2007年（n=994），66%有糖尿病，76%为男性，平均年龄（SD）为67（13）岁。糖尿病和非糖尿病人群中每10万人年的发病率（标准化为2004年德国人群）：男性为176.5（95%置信区间156.0-196.9）和20.0（17.0-23.1），女性为76.9（61.9-91.8）和13.4（10.7-16.2）。标准化相对危险度：男性8.8（7.3-10.7），女性5.7（4.3-7.6）。暴露的可归因风险：0.89和0.83和人口归因风险0.59和0.40，分别在男性和女性，respectively.Discussion：在我们的第一个德国全国性的研究中，我们发现下肢截肢的相对风险在糖尿病患者相比，非糖尿病患者要低于在早期的区域研究在德国，支持结果的区域减少的过度截肢的风险，由于糖尿病。有必要重复这项研究，以便根据圣文森特目标进一步评估趋势。
Introduction: One major objective is to reduce the risk of lower limb amputation in diabetes mellitus. Nationwide data to incidences of amputations in the diabetic and non-diabetic populations in Germany as well as relative and attributable risks due to diabetes are lacking so far.Material and Methods: Using data of a nationwide statutory health insurance (1.6 million members), we assessed all first non-traumatic lower-limb amputations between 2005 and 2007. We estimated sex-age-specific and standardized incidences of amputations in the diabetic and non-diabetic populations, and relative and attributable risks due to diabetes.Results: Of all subjects with a first amputation in the study period 2005-2007 (n=994), 66% had diabetes, 76% were male, mean age (SD) was 67 (13) years. Incidences per 100000 person years (standardized to the 2004 German population) in the diabetic and the non-diabetic populations: 176.5 (95% confidence interval 156.0-196.9) and 20.0 (17.0-23.1) in men, and 76.9 (61.9-91.8) and 13.4 (10.7-16.2) in women. Standardized relative risks: 8.8 (7.3-10.7) in men and 5.7 (4.3-7.6) in women. Attributable risks among exposed: 0.89 and 0.83 and population attributable risks 0.59 and 0.40, each in men and women, respectively.Discussion: In our first German nationwide study, we found the relative risk of lower limb amputation in the diabetic compared to the nondiabetic to be lower than in earlier regional studies in Germany, supporting results of regional reductions of the excess amputation risk due to diabetes. A repetition of the study is warranted to further evaluate trends according to the St. Vincent goals.