Nationwide diabetes-related lower extremity amputation rates in secondary care treated patients with diabetes in the Netherlands (DUDE-7)

• Published in: Journal of diabetes and its complications 2017-04, Vol.31 (4), p.675-678
• Main Authors: Nijenhuis-Rosien, L, Hendriks, S.H, Kleefstra, N, Bilo, H.J.G, Landman, G.W.D
• Format: Article
• Language: English
• Subjects: Age; Aged; Amputation; Codes; Cohort Studies; Combined Modality Therapy; Complications; Confidence intervals; Diabetes; Diabetes Mellitus - therapy; Diabetic Angiopathies - complications; Diabetic Angiopathies - physiopathology; Diabetic Angiopathies - prevention & control; Diabetic Angiopathies - surgery; Diabetic foot; Diabetic Foot - complications; Diabetic Foot - physiopathology; Diabetic Foot - prevention & control; Diabetic Foot - surgery; Diabetic retinopathy; Diabetic Retinopathy - complications; Diabetic Retinopathy - physiopathology; Diabetic Retinopathy - prevention & control; Diabetic Retinopathy - therapy; Endocrinology & Metabolism; Female; Foot diseases; Humans; Insurance, Health, Reimbursement; Leg ulcers; Lower Extremity; Male; Mens health; Microvessels - physiopathology; Middle Aged; Netherlands; Peripheral arterial disease; Peripheral Arterial Disease - complications; Peripheral Arterial Disease - physiopathology; Peripheral Arterial Disease - prevention & control; Peripheral Arterial Disease - surgery; Primary care; Retina; Retinopathy; Retrospective Studies; Secondary Care; Severity of Illness Index; Studies
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2017.01.015

Abstract Aims To estimate the annual amputation rate in all secondary care treated patients with diabetes in the Netherlands and specifically in patients known with diabetic retinopathy. Methods A nationwide population-based retrospective cohort study was performed including the years 2007–2011. Data of patients was retrieved from reimbursement registries for hospital care from a nationwide insurance database including codes for diabetes, retinopathy and amputation. Traumatic amputations were excluded. Results The number of patients with secondary care treated diabetes increased from 132.499 to 137.049 over the years 2007–2011 in the Netherlands. The annual rate of non-traumatic lower-extremity amputations ranged from 4.32 to 5.28 amputations per 1.000 patients. For patients diagnosed with non-proliferative and (pre-) proliferative diabetic retinopathy, the mean amputation rates were 7.9 per 1.000 and 14.7 per 1.000, respectively. Conclusion The Dutch annual incidence rates of non-traumatic lower extremity amputations in secondary care treated patients with diabetes is relatively low and remained stable over the years 2007 to 2011. The amputation rate in patients with retinopathy was substantially higher compared to patients without retinopathy.