Background. Diabetic foot is one of the leading causes of patient disability worldwide. Lower-extremity amputations (LEAs) resulting from this disease massively decrease quality of life, the function of the patient, and incur significant healthcare costs. The aim of this study was to assess trends in the number of amputations, the diagnosis at discharge, and diagnosis-related mortality after LEA procedures in a nationwide population. Methods. Datasets of the National Heath Fund containing information about all services within the public healthcare system in Poland, spanning the years 2010-2019, were analyzed. The source of data regarding mortality was the database of the Polish Ministry of Digital Affairs. Results. Between 2010 and 2019, the annual number of amputations in patients with diabetes increased significantly from 5,049 to 7,759 ( for ). However, the number of amputations in patients with diabetes calculated as a number per 100,000 diabetics decreased significantly ( for ) during this period. Amputations in patients with diabetes accounted for a majority of all amputations; the mean percentage of amputations in patients with diabetes was 68.6% of all amputations (from 61.1% in 2010 to 71.4% in 2019, for ). The most common disease diagnosed at discharge after LEA in diabetic patients was diabetes itself. Vascular pathologies, such as soft-tissue/bone/joint infections and ulcerations, were the next most common. The 30-day mortality rate after LEA was rather high in patients with, as well as without, diabetes (depending on the cause for amputation 3.5-34% and 2.2-28.99%, respectively). Conclusions. The number of LEA in patients with diabetes in Poland increased substantially between 2010 and 2019 along with an increasing number of diabetics. Vascular pathologies, infections, and ulcerations were the most common causes of LEA. The 30-day mortality rate after amputation was rather high and varied depending on the diagnoses at discharge.

中文翻译：

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糖尿病患者下肢截肢：原因和 30 天死亡率

背景。糖尿病足是全球患者残疾的主要原因之一。由这种疾病导致的下肢截肢 (LEA) 会大大降低生活质量、患者的功能，并产生大量的医疗保健费用。本研究的目的是评估全国人群 LEA 手术后截肢次数、出院诊断和诊断相关死亡率的趋势。方法。分析了包含波兰公共医疗保健系统内所有服务信息的国家健康基金数据集，跨越 2010-2019 年。有关死亡率的数据来源是波兰数字事务部的数据库。结果. 2010 年至 2019 年间，糖尿病患者每年截肢的人数从 5,049 人显着增加至 7,759 人（对于）。然而，按照每 100,000 名糖尿病患者的数量计算，糖尿病患者的截肢数量显着下降（对于)在此期间。糖尿病患者的截肢占所有截肢的大部分；糖尿病患者截肢的平均百分比为所有截肢的 68.6%（从 2010 年的 61.1% 到 2019 年的 71.4%，对于）。糖尿病患者 LEA 后出院时诊断出的最常见疾病是糖尿病本身。其次是血管病变，例如软组织/骨/关节感染和溃疡。LEA 后 30 天死亡率在糖尿病患者和非糖尿病患者中相当高（取决于截肢原因，分别为 3.5-34% 和 2.2-28.99%）。结论。2010 年至 2019 年间，波兰糖尿病患者的 LEA 数量随着糖尿病患者数量的增加而大幅增加。血管病变、感染和溃疡是 LEA 最常见的原因。截肢后 30 天的死亡率相当高，并且因出院时的诊断而异。