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Epidemiology/Health Services/Psychosocial Research

Age and Sex May Significantly Interact With Diabetes on the Risks of Lower-Extremity Amputation and Peripheral Revascularization Procedures

Evidence from a cohort of a half-million diabetic patients

  1. Hua-Fen Chen, MD, MSC12,
  2. Ching-An Ho, MD3 and
  3. Chung-Yi Li, PHD2
  1. 1Department of Endocrinology, Far Eastern Memorial Hospital, Taipei Hsien, Taiwan
  2. 2Department of Public Health, College of Medicine, Fu Jen Catholic University, Taipei Hsien, Taiwan
  3. 3Department of Orthopedic Surgery, Catholic Mercy Hospital, Hsinchu Hsien, Taiwan
  1. Address correspondence and reprint requests to Dr. Chung-Yi Li, Department of Public Health, College of Medicine, Fu Jen Catholic University, 510 Chung Cheng Rd., Hsinchuang, Taipei Hsien, 242 Taiwan. E-mail: chungyi{at}mails.fju.edu.tw
Diabetes Care 2006 Nov; 29(11): 2409-2414. https://doi.org/10.2337/dc06-1343
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    Figure 1—

    Kaplan-Meier survival curves for LEA (A) and PRP (B).

Tables

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  • Table 1—

    Overall and age- and sex-specific incidence densities and relative hazards of nontraumatic LEA (ICD-9: 84.1 and 84.10–84.18) in the diabetic and control groups

    Variables*Control group
    Diabetic group
    Adjusted HR (95% CI)‡ in association with diabetic group
    Patients (n)No. of eventsID (per 100,000 patient-years) (95% CI)†Patients (n)No. of eventsID (per 100,000 patient-years) (95% CI)†
    Men (years of age)
        <357,333007,3323586.8 (58.1–115.6)NA§
        35–4425,0171311.2 (5.1–17.3)25,010232169.6 (147.8–191.4)14.12 (8.07–24.70)
        45–5447,1143515.6 (10.4–20.8)47,078724283.1 (262.5–303.7)17.40 (12.39–24.43)
        55–6463,51210536.6 (29.6–43.7)63,4631,538460.5 (437.4–483.5)12.44 (10.21–15.17)
        65–7469,76822064.3 (55.8–72.8)69,7011,840526.9 (502.9–551.0)8.30 (7.21–9.55)
        75–8420,541109121.8 (98.9–144.6)20,511574635.7 (583.7–687.7)5.40 (4.39–6.64)
        >841,369362.3 (−8.2 to 132.8)1,36829585.2 (372.2–798.2)10.56 (3.20–34.89)
        Total234,65448544.4 (40.5–48.4)234,4634,972410.3 (398.9–421.7)9.22 (8.39–10.12)
    Women (years of age)
        <357,83013.2 (−3.1 to 9.4)7,8303171.0 (46.0–96.0)22.17 (3.02–162.85)
        35–4419,31566.5 (1.3–11.8)19,310148137.0 (115.0–159.1)19.82 (8.76–44.86)
        45–5449,469156.4 (3.2–9.6)49,450512185.5 (169.4–201.6)27.92 (16.71–46.66)
        55–6483,5497318.5 (14.3–22.7)83,5251,288282.3 (266.9–297.7)15.10 (11.91–19.15)
        65–7477,40913335.0 (29.0–40.9)77,3641,747436.6 (416.1–457.1)12.44 (10.42–14.85)
        75–8425,9929985.7 (68.8–102.6)25,965697587.9 (544.2–631.5)6.93 (5.60–8.58)
        >842,02411149.6 (61.2–238.0)2,01648644.5 (462.2–826.9)4.25 (2.20–8.24)
        Total265,58833826.9 (24.0–29.8)265,4604,471317.0 (307.0–326.3)11.67 (10.44–13.05)
    • *

      ↵* Inconsistency between total population and population summed for individual variables was due to missing information.

    • †

      ↵† Based on Poisson assumption.

    • ‡

      ↵‡ Based on Cox proportional hazard regression with adjustment for age, sex, geographic area, and urbanization status.

    • §

      ↵§ Not applicable (NA) due to no event of clinical end points for the control group <35 years of age. ID, incidence density.

  • Table 2—

    Overall and age- and sex-specific incidence density and relative hazards of nontraumatic PRP (ICD-9: 39.25, 39.29, and 39.59) in the diabetic and control groups

    Variables*Control group
    Diabetic group
    Adjusted HR (95% CI)‡ in association with diabetic group
    Patients (n)No. of eventsID (per 100,000 patient-years) (95% CI)†Patients (n)No. of eventsID (per 100,000 patient-years) (95% CI)†
    Men (years of age)
    <357,33327.0 (−2.7 to 16.7)7,333819.8 (6.1–33.5)2.71 (0.57–12.88)
    35–4425,01721.7 (−0.677 to 4.1)25,0184129.9 (20.7–39.0)15.68 (3.80–65.24)
    45–5447,1142310.3 (6.1–14.4)47,11214656.7 (47.5–65.9)3.99 (3.11–5.11)
    55–6463,5117024.4 (18.7–30.2)63,502429127.4 (115.4–139.5)5.05 (3.91–6.52)
    65–7469,76919657.3 (49.3–65.3)69,749629178.8 (164.9–192.8)3.06 (2.60–3.60)
    75–8420,5424853.6 (38.4–68.7)20,538146160.1 (134.2–186.1)3.03 (2.18–4.22)
    >841,369120.8 (−19.97 to 61.5)1,369599.9 (12.3–187.5)5.51 (0.63–47.89)
    Total234,65534231.3 (28.0–34.6)234,7221,405115.2 (109.1–121.2)3.56 (3.18–4.03)
    Women (years of age)
    <357,830007,8301125.2 (10.3–40.1)NA§
    35–4419,31555.5 (0.7–10.2)19,3123633.2 (22.4–44.1)6.00 (2.34–15.22)
    45–5449,469135.5 (2.5–8.5)49,46613849.8 (41.5–58.2)8.72 (4.93–15.41)
    55–6483,5497519.0 (14.7–23.3)83,54536780.1 (71.9–88.2)3.99 (3.11–5.11)
    65–7477,41112933.9 (28.1–39.8)77,406528131.0 (119.9–142.2)3.82 (3.14–4.64)
    75–8425,9934539.0 (27.6–50.3)25,990130108.5 (89.9–127.2)2.81 (1.99–3.96)
    >842,024227.1 (−10.57 to 64.7)2,02410132.5 (50.4–214.7)4.61 (0.99–21.50)
    Total265,59126921.4 (18.9–24.0)265,6291,22086.0 (81.2–90.9)3.92 (3.43–4.47)
    • *

      ↵* Inconsistency between total population and population summed for individual variables was due to missing information.

    • †

      ↵† Based on Poisson assumption.

    • ‡

      ↵‡ Based on Cox proportional hazard regression with adjustment for age, sex, geographic area, and urbanization status.

    • §

      ↵§ Not applicable (NA) due to no event of clinical end points for the control group <35 years of age. ID, incidence density.

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Diabetes Care: 29 (11)

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Age and Sex May Significantly Interact With Diabetes on the Risks of Lower-Extremity Amputation and Peripheral Revascularization Procedures
Hua-Fen Chen, Ching-An Ho, Chung-Yi Li
Diabetes Care Nov 2006, 29 (11) 2409-2414; DOI: 10.2337/dc06-1343

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Age and Sex May Significantly Interact With Diabetes on the Risks of Lower-Extremity Amputation and Peripheral Revascularization Procedures
Hua-Fen Chen, Ching-An Ho, Chung-Yi Li
Diabetes Care Nov 2006, 29 (11) 2409-2414; DOI: 10.2337/dc06-1343
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