Incidencia de amputaciones mayores secundarias a pie diabético antes y después revascularización endovascular

Abstract

Objective: The objective of the study was to compare the incidence of major amputation of the lower limbs secondary to the diabetic foot (DF) before and after the introduction of endovascular therapy as a method of revascularization in patients with severe ischemia. Methods: This retrospective, observational, and longitudinal study evaluated patients diagnosed with DF from June 2012 to June 2019. The incidence of major amputation was compared with prior endovascular revascularization and subsequent use 2016 as the reference year. We compared the higher amputation rates between the two time periods using the Chi-square test at a significance level of 0.05. Results: A total of 860 patients, 218 (60%) underwent endovascular revascularization. The absolute risk of major amputation was 56% (95% confidence interval [CI], 0.50-0.52; odds ratio [OR], 1.29) in the first period of time and 19% (95% CI, OR, 0.24) in the second period of time, with an OR of 0.19 (95% CI, 0.14-0.26), relative risk of 0.33, risk reduction relative of 0.66, and risk difference of 0.37. The difference in the incidence of major amputation between the two time distances was statistically significant. Conclusions: The incidence of PD is increasing overtime. Revascularization through an endovascular approach may be a feasible alternative to reduce significant amputation rates, even in countries with a high incidence of diabetes. However, more studies are required to support these conclusions.

Revascularization prevents amputation among patients with diabetic foot during the COVID-19 era

“…1,2 Prior to the COVID-19 era, specialized centers for DF prevention and treatment increased limb salvage and transformed the paradigm of peripheral arterial disease (PAD) treatment by using techniques such as endovascular revascularization, center-based patient care, and a multidisciplinary team approach. [3][4][5] However, despite these existing strategies, the number of major amputations among patients with diabetic foot has increased during the COVID-19 era. [6][7][8] As the pandemic continues, it is important to understand how changes in the healthcare system put into place to manage the pandemic have affected presentation and outcomes of patients with DF.…”