Comorbid status in patients with osteomyelitis is associated with long-term incidence of extremity amputation
Introduction Osteomyelitis is associated with significant morbidity, including amputation. There are limited data on long-term amputation rates following an osteomyelitis diagnosis. We sought to determine the incidence of amputation in patients with osteomyelitis over 2 years.Research design and met...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-11-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/11/6/e003611.full |
| _version_ | 1797371416498143232 |
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| author | Armani M Hawes Rodica Pop-Busui Brian M Schmidt Toby P Keeney-Bonthrone Monika Karmakar Lynn M Frydrych Sandro K Cinti Matthew J Delano |
| author_facet | Armani M Hawes Rodica Pop-Busui Brian M Schmidt Toby P Keeney-Bonthrone Monika Karmakar Lynn M Frydrych Sandro K Cinti Matthew J Delano |
| author_sort | Armani M Hawes |
| collection | DOAJ |
| description | Introduction Osteomyelitis is associated with significant morbidity, including amputation. There are limited data on long-term amputation rates following an osteomyelitis diagnosis. We sought to determine the incidence of amputation in patients with osteomyelitis over 2 years.Research design and methods Observational cohort study of 1186 inpatients with osteomyelitis between 2004 and 2015 and stratified by osteomyelitis location status to evaluate the impact on amputation, mortality rates, readmission data, and inpatient days.Results Persons with diabetes had 3.65 times greater probability of lower extremity amputation (p<0.001), readmission (p<0.001), and longer inpatient stay (p<0.001) and had higher 2-year mortality (relative risk (RR) 1.23, p=0.0027), adjusting for risk factors. Male gender (RR 1.57, p<0.001), black race (RR 1.41, p<0.05), former smoking status (RR 1.38, p<0.01), myocardial infarction (RR 1.72, p<0.001), congestive heart failure (RR 1.56, p<0.001), peripheral vascular disease (RR 2.25, p<0.001) and renal disease (RR 1.756, p<0.001) were independently associated with amputation. Male gender (RR 1.39, p<0.01), black race (RR 1.27, p<0.05), diabetes (RR 2.77, p<0.001) and peripheral vascular disease (RR 1.59, p<0.001) had increased risk of lower, not upper, extremity amputation.Conclusions Patients with osteomyelitis have higher rates of amputation and hospitalization. Clinicians must incorporate demographic and comorbid risk factors to protect against amputation. |
| first_indexed | 2024-03-08T18:19:38Z |
| format | Article |
| id | doaj.art-73affd44d2844e1ab993eeeb5925ada2 |
| institution | Directory Open Access Journal |
| issn | 2052-4897 |
| language | English |
| last_indexed | 2024-03-08T18:19:38Z |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Diabetes Research & Care |
| spelling | doaj.art-73affd44d2844e1ab993eeeb5925ada22023-12-31T02:30:09ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972023-11-0111610.1136/bmjdrc-2023-003611Comorbid status in patients with osteomyelitis is associated with long-term incidence of extremity amputationArmani M Hawes0Rodica Pop-Busui1Brian M Schmidt2Toby P Keeney-Bonthrone3Monika Karmakar4Lynn M Frydrych5Sandro K Cinti6Matthew J Delano7Department of Surgery, University of Michigan, Ann Arbor, Michigan, USAInternal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USAInternal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USADepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USADepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USADepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USAInternal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USADepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USAIntroduction Osteomyelitis is associated with significant morbidity, including amputation. There are limited data on long-term amputation rates following an osteomyelitis diagnosis. We sought to determine the incidence of amputation in patients with osteomyelitis over 2 years.Research design and methods Observational cohort study of 1186 inpatients with osteomyelitis between 2004 and 2015 and stratified by osteomyelitis location status to evaluate the impact on amputation, mortality rates, readmission data, and inpatient days.Results Persons with diabetes had 3.65 times greater probability of lower extremity amputation (p<0.001), readmission (p<0.001), and longer inpatient stay (p<0.001) and had higher 2-year mortality (relative risk (RR) 1.23, p=0.0027), adjusting for risk factors. Male gender (RR 1.57, p<0.001), black race (RR 1.41, p<0.05), former smoking status (RR 1.38, p<0.01), myocardial infarction (RR 1.72, p<0.001), congestive heart failure (RR 1.56, p<0.001), peripheral vascular disease (RR 2.25, p<0.001) and renal disease (RR 1.756, p<0.001) were independently associated with amputation. Male gender (RR 1.39, p<0.01), black race (RR 1.27, p<0.05), diabetes (RR 2.77, p<0.001) and peripheral vascular disease (RR 1.59, p<0.001) had increased risk of lower, not upper, extremity amputation.Conclusions Patients with osteomyelitis have higher rates of amputation and hospitalization. Clinicians must incorporate demographic and comorbid risk factors to protect against amputation.https://drc.bmj.com/content/11/6/e003611.full |
| spellingShingle | Armani M Hawes Rodica Pop-Busui Brian M Schmidt Toby P Keeney-Bonthrone Monika Karmakar Lynn M Frydrych Sandro K Cinti Matthew J Delano Comorbid status in patients with osteomyelitis is associated with long-term incidence of extremity amputation BMJ Open Diabetes Research & Care |
| title | Comorbid status in patients with osteomyelitis is associated with long-term incidence of extremity amputation |
| title_full | Comorbid status in patients with osteomyelitis is associated with long-term incidence of extremity amputation |
| title_fullStr | Comorbid status in patients with osteomyelitis is associated with long-term incidence of extremity amputation |
| title_full_unstemmed | Comorbid status in patients with osteomyelitis is associated with long-term incidence of extremity amputation |
| title_short | Comorbid status in patients with osteomyelitis is associated with long-term incidence of extremity amputation |
| title_sort | comorbid status in patients with osteomyelitis is associated with long term incidence of extremity amputation |
| url | https://drc.bmj.com/content/11/6/e003611.full |
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