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Risk factors for lower extremity amputation among patients with diabetes in Singapore.

Publication ,  Journal Article
Yang, Y; Østbye, T; Tan, SB; Abdul Salam, Z-H; Ong, BC; Yang, KS
Published in: J Diabetes Complications
2011

BACKGROUND: Among other risk factors, renal disease and ethnicity have been associated with diabetic lower extremity amputation (LEA) in Western populations. However, little is known about risk factors for LEA among Asian patients. OBJECTIVE: The objective was to assess the proportion of hospitalized patients with diabetes who have a LEA among all hospital patients with diabetes mellitus (DM) and to investigate risk factors for diabetic LEA (especially renal disease and ethnicity) using hospital discharge database. METHOD: A retrospective study of hospital discharge database (2004-2009) was performed to identify patients with DM, LEA and renal disease using the International Statistical Classification of Diseases and Related Health Problems, Ninth Revision, Australian Modification codes. RESULTS: Of 44 917 hospitalized patients with DM during the 6 years, 7312 (16.3%) patients had renal disease, and 1457 (3.2%) patients had LEA. DM patients with renal disease had significant higher rates of LEA (7.1%) compared to DM patients without renal disease (2.5%, P < .001). The differences were present for foot (2.7% vs. 1.2%), ankle or leg (2.8% vs. 0.9%), and knee or above amputation (1.6% vs. 0.4%, all P<.001). Malays had the highest rate of diabetic LEA (5.1%), followed by Indians (3.0%), Chinese (3.0%), and others (2.3%, P < .001). In logistic regression analyses, renal disease and ethnicity were significant predictors of diabetic LEA (renal disease: odds ratio 3.2, 95% confidence interval 2.8-3.6; ethnicity: odds ratio, 1.6, Malays vs. Chinese, P < .001; 1.0, Indians vs. Chinese, P = .784) after adjustment for age, gender, and year of discharge. CONCLUSION: DM patients with renal disease and Malay ethnicity had higher rates of LEA in this Asian patient population. Malay patients with DM and diabetic patients with renal disease should be considered as high-risk groups for LEA and therefore screened and monitored systematically.

Duke Scholars

Published In

J Diabetes Complications

DOI

EISSN

1873-460X

Publication Date

2011

Volume

25

Issue

6

Start / End Page

382 / 386

Location

United States

Related Subject Headings

  • Singapore
  • Risk Factors
  • Retrospective Studies
  • Renal Insufficiency
  • Middle Aged
  • Male
  • Malaysia
  • Lower Extremity
  • India
  • Humans
 

Citation

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MLA
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Yang, Y., Østbye, T., Tan, S. B., Abdul Salam, Z.-H., Ong, B. C., & Yang, K. S. (2011). Risk factors for lower extremity amputation among patients with diabetes in Singapore. J Diabetes Complications, 25(6), 382–386. https://doi.org/10.1016/j.jdiacomp.2011.08.002
Yang, Yong, Truls Østbye, Say Beng Tan, Zakir-Hussain Abdul Salam, Biauw Chi Ong, and Kok Soong Yang. “Risk factors for lower extremity amputation among patients with diabetes in Singapore.J Diabetes Complications 25, no. 6 (2011): 382–86. https://doi.org/10.1016/j.jdiacomp.2011.08.002.
Yang Y, Østbye T, Tan SB, Abdul Salam Z-H, Ong BC, Yang KS. Risk factors for lower extremity amputation among patients with diabetes in Singapore. J Diabetes Complications. 2011;25(6):382–6.
Yang, Yong, et al. “Risk factors for lower extremity amputation among patients with diabetes in Singapore.J Diabetes Complications, vol. 25, no. 6, 2011, pp. 382–86. Pubmed, doi:10.1016/j.jdiacomp.2011.08.002.
Yang Y, Østbye T, Tan SB, Abdul Salam Z-H, Ong BC, Yang KS. Risk factors for lower extremity amputation among patients with diabetes in Singapore. J Diabetes Complications. 2011;25(6):382–386.
Journal cover image

Published In

J Diabetes Complications

DOI

EISSN

1873-460X

Publication Date

2011

Volume

25

Issue

6

Start / End Page

382 / 386

Location

United States

Related Subject Headings

  • Singapore
  • Risk Factors
  • Retrospective Studies
  • Renal Insufficiency
  • Middle Aged
  • Male
  • Malaysia
  • Lower Extremity
  • India
  • Humans