| Title |
Lower-extremity amputations in people with and without diabetes in Germany, 2008–2012 – an analysis of more than 30 million inhabitants
|
|---|---|
| Published in |
Clinical Epidemiology, April 2018
|
| DOI | 10.2147/clep.s146484 |
| Pubmed ID | |
| Authors |
Heiner Claessen, Maria Narres, Burkhard Haastert, Werner Arend, Falk Hoffmann, Stephan Morbach, Gerhard Rümenapf, Tatjana Kvitkina, Heiko Friedel, Christian Günster, Ingrid Schubert, Walter Ullrich, Benjamin Westerhoff, Adrian Wilk, Andrea Icks |
| Abstract |
Lower-extremity amputations (LEAs) in people with diabetes are associated with reduced quality of life and increased health care costs. Detailed knowledge on amputation rates (ARs) is of utmost importance for future health care and economics strategies. We conducted the present cohort study in order to estimate the incidences of LEA as well as relative and attributable risk due to diabetes and to investigate time trends for the period 2008-2012. On the basis of the administrative data from three large branches of German statutory health insurers, covering ~34 million insured people nationwide (about 40% of the German population), we estimated age-sex-standardized AR (first amputation per year) in the populations with and without diabetes for any, major, and minor LEAs. Time trends were analyzed using Poisson regression. A total of 108,208 individuals (diabetes: 67.3%; mean age 72.6 years) had at least one amputation. Among people with diabetes, we observed a significant reduction in major and minor ARs during 2008-2012 from 81.2 (95% CI 77.5-84.9) to 58.4 (55.0-61.7), and from 206.1 (197.3-214.8) to 177.0 (169.7-184.4) per 100,000 person-years, respectively. Among people without diabetes, the major AR decreased significantly from 14.3 (13.9-14.8) to 11.6 ([11.2-12.0], 12.0), whereas the minor AR increased from 15.8 (15.3-16.3) to 17.0 (16.5-17.5) per 100,000 person-years. The relative risk (RR) comparing the diabetic with the nondiabetic populations decreased significantly for both major and minor LEAs (4% and 5% annual reduction, respectively). In this large nationwide population, we still found higher major and minor ARs among people with diabetes compared with those without diabetes. However, AR and RR of major and minor LEAs in the diabetic compared with the nondiabetic population decreased significantly during the study period, confirming a positive trend that has been observed in smaller and regional studies in recent years. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Germany | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 53 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 53 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 9 | 17% |
| Other | 5 | 9% |
| Student > Postgraduate | 5 | 9% |
| Student > Master | 4 | 8% |
| Student > Doctoral Student | 2 | 4% |
| Other | 8 | 15% |
| Unknown | 20 | 38% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 12 | 23% |
| Nursing and Health Professions | 8 | 15% |
| Engineering | 4 | 8% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
| Agricultural and Biological Sciences | 1 | 2% |
| Other | 3 | 6% |
| Unknown | 24 | 45% |
Attention Score in Context
This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 July 2018.
All research outputs
#2,981,223
of 23,056,273 outputs
Outputs from Clinical Epidemiology
#131
of 728 outputs
Outputs of similar age
#64,260
of 330,211 outputs
Outputs of similar age from Clinical Epidemiology
#10
of 29 outputs
Altmetric has tracked 23,056,273 research outputs across all sources so far. Compared to these this one has done well and is in the 86th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 728 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.4. This one has done well, scoring higher than 81% of its peers.
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We're also able to compare this research output to 29 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 65% of its contemporaries.