Postoperative outcomes of major lower extremity amputations in patients with diabetes and peripheral artery disease: analysis using the Diagnosis Procedure Combination database in Japan

Am J Surg. 2016 Sep;212(3):446-50. doi: 10.1016/j.amjsurg.2015.08.039. Epub 2016 Jan 6.


Background: The purpose of the present study was to investigate 30-day postoperative outcomes after lower extremity amputation in patients with diabetes mellitus (DM) alone, peripheral artery disease (PAD) alone, or both.

Methods: Eight thousand five hundred sixty-five patients with DM alone (n = 2,700), PAD alone (n = 2,919), and both (n = 2,946) who had above-knee amputation or below-knee amputation during 2007 to 2012 from the Japanese Diagnosis Procedure Combination inpatient database were retrospectively analyzed.

Results: Overall 30-day mortality was 6.4% (5.1%, 8.5%, and 5.6% in DM alone, PAD alone and both group, respectively). Multivariable regression analysis showed no significant differences in 30-day mortality or overall postoperative complication rates among the 3 groups. Patients with both PAD and DM had a significantly higher proportion of cardiac events than those with DM alone (6.9% vs 3.0%; odds ratio = 2.27; 95% confidence interval = 1.73 to 2.98).

Conclusions: Patients with both DM and PAD were more likely to have postoperative cardiac events.

Keywords: Cardiac events; Diabetes mellitus; Lower extremity amputation; Mortality; Peripheral artery disease.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Amputation*
  • Female
  • Humans
  • Incidence
  • Japan / epidemiology
  • Lower Extremity / blood supply*
  • Lower Extremity / surgery
  • Male
  • Odds Ratio
  • Peripheral Arterial Disease / surgery*
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Survival Rate / trends
  • Treatment Outcome