Comparison of Outcomes After Revascularization for Acute Lower Limb Ischemia in Patients with and without Type 2 Diabetes Mellitus – A Nationwide Registry Study
Emil Karonen,1,2 Frida Eek,3 Isabel Drake,4 Talha Butt,1,2 Hanne Krage Carlsen,5 Björn Eliasson,6 Anders Gottsäter,1,7 Stefan Acosta1,2 1Department of Clinical Sciences, Lund University, Malmö, Sweden; 2Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Ma...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2025-04-01
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| Series: | Vascular Health and Risk Management |
| Subjects: | |
| Online Access: | https://www.dovepress.com/comparison-of-outcomes-after-revascularization-for-acute-lower-limb-is-peer-reviewed-fulltext-article-VHRM |
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| Summary: | Emil Karonen,1,2 Frida Eek,3 Isabel Drake,4 Talha Butt,1,2 Hanne Krage Carlsen,5 Björn Eliasson,6 Anders Gottsäter,1,7 Stefan Acosta1,2 1Department of Clinical Sciences, Lund University, Malmö, Sweden; 2Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden; 3Department of Health Sciences, Lund University, Lund, Sweden; 4Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden; 5Centre of Registers, National Diabetes Register, Göteborg, Sweden; 6Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Göteborg, Sweden; 7Department of Medicine, Skåne University Hospital, Malmö, SwedenCorrespondence: Emil Karonen, Department of Clinical Sciences, Lund University Ruth Lundskogs Gata 10, Malmö, 205 02, Sweden, Email emil.karonen@med.lu.seIntroduction: Acute lower limb ischemia (ALI) is a life and limb threatening event often affecting patients with type 2 diabetes mellitus (T2DM). Little is known about how T2DM affects the risk of adverse events in patients revascularized for ALI. This study aimed to investigate if there were differences in major outcomes between ALI patients with and without T2DM.Methods: Between 2010 and 2014, 615 patients underwent revascularization for ALI, according to the Swedish Vascular Registry (SWEDVASC). Using the National Diabetes Registry (NDR), 245 (39.8%) of the patients were identified as having T2DM. Uni- and multivariable Cox or logistic regression analyses were performed to evaluate risk differences for major amputation, mortality, major adverse cardiovascular events (MACE), and fasciotomy between patients with and without T2DM.Results: The rates of major amputation and mortality at one year were 32.7% and 21.6% in the T2DM group, compared to 21.9% and 31.9% in the non-DM group, respectively, resulting in a hazard ratio (HR) of 1.52 (95% confidence interval [CI] 1.12– 2.07) for major amputation and HR of 0.64 (95% CI 0.46– 0.88) for mortality. At one year, the HR for major amputation was 1.45 (95% CI 0.99– 2.11), HR for mortality 0.92 (95% CI 0.61– 1.39), HR for combined major amputation/mortality 1.27 (95% CI 0.94– 1.72), and HR for MACE 1.24 (95% CI 0.92– 1.67) for those with T2DM compared to those without in the multivariable Cox-regression analyses. The multivariable logistic regression analysis showed significantly lower odds of fasciotomy, OR 0.1 (95% CI 0.01– 0.51) in the T2DM-group.Conclusion: T2DM was not significantly associated with higher hazard of major amputation, mortality, combined major amputation/mortality, or MACE after revascularization for ALI, compared to patients without T2DM. Patients with T2DM had significantly lower odds of fasciotomy.Keywords: acute lower limb ischemia, type 2 diabetes mellitus, major amputation |
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| ISSN: | 1178-2048 |