OUTCOME AND QUALITY-OF-LIFE OF PATIENTS WITH SEVERE CHRONIC LIMB ISCHEMIA - A COHORT STUDY ON THE INFLUENCE OF DIABETES

Objective: To determine the influence of diabetes on the use of arteri al reconstruction, the rate of amputation and death, and the quality o f life of patients with severe limb ischaemia. Design: A prospective s tudy of patients with the first episode of ischaemia. Setting: Univers ity tertiary referral centre. Methods: Thirty-seven patients with diab etes and 50 without diabetes, were studied over a 12 month period with complete follow-up. Main outcome measures: The proportion of patients undergoing an arterial reconstruction, amputation rate, death rate, a nd quality-of-life scores. Results: Patients with diabetes underwent a n arterial reconstruction less often than patients without diabetes (7 /37 vs. 18/50). The odds of patients with diabetes having a higher inc idence of adverse outcome was 1666:1 for minor amputation, 26:1 for ma jor amputation, and 4.7:1 for death. There was a tendency towards a lo wer quality of life for patients with diabetes at 3 (OR 1.94, p = 0.03 6), 6 (OR 1.58, p = 0.217), and 12 (OR 1.47, p = 0.185) months. Conclu sions: In patients with diabetes, (1) the opportunity of undergoing an arterial reconstruction is lower, (2) morbidity and mortality are hig her and (3) the qualify of life ends to be worse.