75% healing rate in differed between minor amputations. centres (2.4-34%). One explanation is the difference in disease severity at presentation. Author/year Number Patient Outcome Amputation level Follow-up Factors related to Age Re-amputation Comments of patients selection outcome rate 116 Diabetes + non Not reported Minor only 3 years Insulin dependent 66.8±11 57/116 Retrospective (single Kono et al diabetes diabetes and gangrene hospital, veterans) 2012169 were risk factors for 5 year mortality 46% 59 Diabetes 100% only 33.8 months Not reported 63 (39-97) 42.4% new Retrospective chart Borkosky et al amputations on evaluation. Mortality 2013156 same site during 47.5% at final chart study period review. 50 Diabetes 28/50 healed/is Minor only 6 weeks Toe pressure was higher 67.4 (mean Not reported of study is on Caruana et al healing (at 6 weeks in patients healed/healing age) whether ankle 2015157 follow-up) brachial pressure index or toe pressure or ankle waveforms are better to predict healing after minor amputation. 66 Diabetes (all Main outcome 56 Not reported Not reported 68±11 Not reported 2 year mortality 41% Matsuzaki et al patients have mortality, healing (minor amp) 2015194 10 major nephropathy, rate not reported (major amp) PTA and amputation) 565 Diabetes Not reported All amputation levels 35 months Not reported 68±12 Not reported Primary study focus Wiessman et al and major, both was one-year 2015196 above and below mortality. knee) 1-year mortality 35.8% (all patients regardless of amputation level) 165 Diabetes 33/165 (20%) Minor and major Minimum 1 Factors related to <50 y: 28 Not reported Retrospective Beaney et al underwent 34 year amputation: less than 2016168 50-54 y: 14 Case analysis of amputations (17 100% attendance, poor patients referred to 55-64 y: 29 major, 17 minor) glycemic control, diabetic foot clinic 65-74 y: 46 hypertension. y: 49 ≥75 Previous vascular surgery and low comorbidity
75% healing rate in minor amputations. differed between centres (2.4-34%). One explanation is the difference in disease severity at presentation. Author/year Number of patients Patient selection Outcome Amputation level Follow-up Factors related to outcome Age Re-amputation rate Comments Kono et al 2012169 116 Diabetes + non diabetes Not reported Minor only 3 years Insulin dependent diabetes and gangrene were risk factors for 66.8±11 57/116 Retrospective (single hospital, veterans) 5 year mortality 46% Borkosky et al 2013156 59 Diabetes 100% only 33.8 months Not reported 63 (39-97) 42.4% new amputations on same site during study period Retrospective chart evaluation. Mortality 47.5% at final chart review. Caruana et al 2015157 50 Diabetes 28/50 healed/is healing (at 6 weeks follow-up) Minor only 6 weeks Toe pressure was higher in patients healed/healing 67.4 (mean age) Not reported of study is on whether ankle brachial pressure index or toe pressure or ankle waveforms are better to predict healing after minor amputation. Matsuzaki et al 2015194 66 Diabetes (all patients have nephropathy, PTA and amputation) Main outcome mortality, healing rate not reported 56 10 major Not reported Not reported 68±11 Not reported 2 year mortality 41% (minor amp) (major amp) Wiessman et al 2015196 565 Diabetes Not reported All amputation levels and major, both above and below knee) 35 months Not reported 68±12 Not reported Primary study focus was one-year mortality. 1-year mortality 35.8% (all patients regardless of amputation level) Beaney et al 2016168 165 Diabetes 33/165 (20%) underwent 34 amputations (17 major, 17 minor) Minor and major Minimum 1 year Factors related to amputation: less than 100% attendance, poor glycemic control, hypertension. Previous vascular surgery and low comorbidity <50 y: 28 50-54 y: 14 55-64 y: 29 65-74 y: 46 ≥75 y: 49 Not reported Retrospective Case analysis of patients referred to diabetic foot clinic
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