Lower extremity amputations in diabetic and non-diabetic patients in Umbria, Italy

A survey of non-traumatic lower extremity amputations (LEAs) carried out in Umbria, Italy (811,887 inhabitants) in 1991, 1992 and 1993 was made by the Cooperative Study Group (CSG) of the "Progetto Umbria Diabete", The CSG ex amined the registers of all the operating rooms in Umbria to identify the a mputees and their hospital records. Four hundred and ninety LEAs were perfo rmed on 385 subjects during the study period. Diabetic patients were 49.1% of all the amputees but they suffered from 51.3% of all the LEAs. Median ag e at the first amputation was lower in diabetic than in non-diabetic ampute es (74 vs 76 years; p=0.01). The overall incidence of new LEAs was higher i n diabetic than in non-diabetic subjects (33.28/10,000 cases/year vs 1.56/1 0,000 cases/year) and increased with age in both groups and in both sexes. The sex ratio (M/F) among the amputees was 2.9 in non-diabetic subjects and 1.0 in diabetic patients (p<0.0001). An above-knee amputation was more fre quent among the non-diabetic subjects but more diabetic patients underwent 2 or more LEAs. Overall peri-operative mortality was 8.3% without differenc es between diabetic and non-diabetic patients. Finally, the length of hospi talization was 25 days in diabetic patients and 24 days in non-diabetic amp utees. Diab. Nutr. Metab. 11: 188-193, 1998. (C) 1998, Editrice Kurtis.