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Lower extremity reamputation in people with diabetes: a systematic review and meta-analysis

In this study, we determined the reamputation-free survival to both limbs and to the contralateral limb only following an index amputation of any-level and assessed whether reamputation rates have changed over time. We completed a systematic search using PubMed and screened a total of 205 articles f...

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Autores principales: Liu, Rongqi, Petersen, Brian J, Rothenberg, Gary M, Armstrong, David G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8194332/
https://www.ncbi.nlm.nih.gov/pubmed/34112651
http://dx.doi.org/10.1136/bmjdrc-2021-002325
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author Liu, Rongqi
Petersen, Brian J
Rothenberg, Gary M
Armstrong, David G
author_facet Liu, Rongqi
Petersen, Brian J
Rothenberg, Gary M
Armstrong, David G
author_sort Liu, Rongqi
collection PubMed
description In this study, we determined the reamputation-free survival to both limbs and to the contralateral limb only following an index amputation of any-level and assessed whether reamputation rates have changed over time. We completed a systematic search using PubMed and screened a total of 205 articles for data on reamputation rates. We reported qualitative characteristics of 56 studies that included data on reamputation rates and completed a meta-analysis on 22 of the studies which enrolled exclusively participants with diabetes. The random-effects meta-analysis fit a parametric survival distribution to the data for reamputations to both limbs and to the contralateral limb only. We assessed whether there was a temporal trend in the reamputation rate using the Mann-Kendall test. Incidence rates were high for reamputation to both limbs and to the contralateral limb only. At 1 year, the reamputation rate for all contralateral and ipsilateral reamputations was found to be 19% (IQR=5.1%–31.6%), and at 5 years, it was found to be 37.1% (IQR=27.0%–47.2%). The contralateral reamputation rate at 5 years was found to be 20.5% (IQR=13.3%–27.2%). We found no evidence of a trend in the reamputation rates over more than two decades of literature analyzed. The incidence of lower extremity reamputation is high among patients with diabetes who have undergone initial amputations secondary to diabetes, and rates of reamputation have not changed over at least two decades.
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spelling pubmed-81943322021-06-28 Lower extremity reamputation in people with diabetes: a systematic review and meta-analysis Liu, Rongqi Petersen, Brian J Rothenberg, Gary M Armstrong, David G BMJ Open Diabetes Res Care Epidemiology/Health services research In this study, we determined the reamputation-free survival to both limbs and to the contralateral limb only following an index amputation of any-level and assessed whether reamputation rates have changed over time. We completed a systematic search using PubMed and screened a total of 205 articles for data on reamputation rates. We reported qualitative characteristics of 56 studies that included data on reamputation rates and completed a meta-analysis on 22 of the studies which enrolled exclusively participants with diabetes. The random-effects meta-analysis fit a parametric survival distribution to the data for reamputations to both limbs and to the contralateral limb only. We assessed whether there was a temporal trend in the reamputation rate using the Mann-Kendall test. Incidence rates were high for reamputation to both limbs and to the contralateral limb only. At 1 year, the reamputation rate for all contralateral and ipsilateral reamputations was found to be 19% (IQR=5.1%–31.6%), and at 5 years, it was found to be 37.1% (IQR=27.0%–47.2%). The contralateral reamputation rate at 5 years was found to be 20.5% (IQR=13.3%–27.2%). We found no evidence of a trend in the reamputation rates over more than two decades of literature analyzed. The incidence of lower extremity reamputation is high among patients with diabetes who have undergone initial amputations secondary to diabetes, and rates of reamputation have not changed over at least two decades. BMJ Publishing Group 2021-06-10 /pmc/articles/PMC8194332/ /pubmed/34112651 http://dx.doi.org/10.1136/bmjdrc-2021-002325 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Epidemiology/Health services research
Liu, Rongqi
Petersen, Brian J
Rothenberg, Gary M
Armstrong, David G
Lower extremity reamputation in people with diabetes: a systematic review and meta-analysis
title Lower extremity reamputation in people with diabetes: a systematic review and meta-analysis
title_full Lower extremity reamputation in people with diabetes: a systematic review and meta-analysis
title_fullStr Lower extremity reamputation in people with diabetes: a systematic review and meta-analysis
title_full_unstemmed Lower extremity reamputation in people with diabetes: a systematic review and meta-analysis
title_short Lower extremity reamputation in people with diabetes: a systematic review and meta-analysis
title_sort lower extremity reamputation in people with diabetes: a systematic review and meta-analysis
topic Epidemiology/Health services research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8194332/
https://www.ncbi.nlm.nih.gov/pubmed/34112651
http://dx.doi.org/10.1136/bmjdrc-2021-002325
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