Evidence map›Paper›PMID 39217619›Full record

Observational studyJournal of foot and ankle research2024

Exploring potential risk factors for lower limb amputation in people with diabetes-A national observational cohort study in Sweden.

Simon Ramstrand, Michael Carlberg, Gustav Jarl, Anton Johannesson, Ayako Hiyoshi, Stefan Jansson

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of foot and ankle research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Risk Factors Associated with Amputation for Patients with Diabetic Foot Ulcers: A Retrospective Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Simon RamstrandFaculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden.ORCID https://orcid.org/0000-0002-5858-5481
Michael CarlbergClinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Gustav JarlFaculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden.
Anton JohannessonÖssur Clinics Scandinavia, Stockholm, Sweden.
Ayako HiyoshiClinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Stefan JanssonFaculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden.

Funding

Nyckelfonden OLL-935285Nyckelfonden OLL-961351Research committee, Region Örebro OLL-779571Stiftelsen Promobilia A21018Swedish Foundation for International Cooperation in Research and Higher Education
6 · The paper itself

Abstract

aimsRisk factors for lower limb amputation (LLA) in individuals with diabetes have been under-studied. We examined how 1/demographic and socioeconomic, 2/medical, and 3/lifestyle risk factors may be associated with LLA in people with newly diagnosed diabetes.

methodsUsing the Swedish national diabetes register from 2007 to 2016, we identified all individuals ≥18 years with an incident diabetes diagnosis and no previous amputation. These individuals were followed from the date of diabetes diagnosis to amputation, emigration, death, or the end of the study in 2017 using data from the In-Patient Register and the Total Population Register. The cohort consisted of 66,569 individuals. Information about demographic, socioeconomic, medical, and lifestyle risk factors was ascertained around the time of the first recorded diabetes diagnosis, derived from the above-mentioned registers. Cox proportional hazard models were used to obtain hazard ratios (HR) with 95% confidence intervals (CI).

resultsDuring the median follow-up time of 4 years, there were 133 individuals with LLA. The model adjusting for all variables showed a higher risk for LLA with higher age, HR 1.08 (95% CI 1.05-1.10), male sex, HR 1.57 (1.06-2.34), being divorced, HR 1.67 (1.07-2.60), smokers HR 1.99 (1.28-3.09), insulin treated persons HR 2.03 (1.10-3.74), people with low physical activity (PA) HR 2.05 (1.10-3.74), and people with an increased foot risk at baseline HR > 4.12. People with obesity had lower risk, HR 0.46 (0.29-0.75).

conclusionsThis study found a higher risk for LLA among people with higher age, male sex, who were divorced, had a higher foot risk group, were on insulin treatment, had lower PA levels, and were smokers. No significant association was found between risk for LLA and education level, country of origin, type of diabetes, blood glucose level, hypertension, hyperlipidemia, creatinine level, or glomerular filtration rate. Obesity was associated with lower risk for LLA. Identified variables may have important roles in LLA risk among people with diabetes.

Indexed as

Amputation, SurgicalLower ExtremityAgedAged, 80 and overCohort StudiesDiabetes MellitusDiabetic FootFemaleHumansLife StyleMaleMiddle AgedProportional Hazards ModelsRegistriesRisk FactorsSwedenamputationdiabetesdiabetic footregister studyrisk factors

Identifiers

PMID39217619
PMCPMC11366273

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.