Outcome and quality of life of patients with severe chronic limb ischaemia: a cohort study on the influence of diabetes.

Abstract

To determine the influence of diabetes on the use of arterial reconstruction, the rate of amputation and death, and the quality of life of patients with severe limb ischaemia. A prospective study of patients with the first episode of ischaemia. University tertiary referral centre. Thirty-seven patients with diabetes and 50 without diabetes, were studied over a 12 month period with complete follow-up. The proportion of patients undergoing an arterial reconstruction, amputation rate, death rate, and quality-of-life scores. Patients with diabetes underwent an arterial reconstruction less often than patients without diabetes (7/37 vs. 18/50). The odds of patients with diabetes having a higher incidence of adverse outcome was 1666:1 for minor amputation, 26:1 for major amputation, and 4.7:1 for death. There was a tendency towards a lower quality of life for patients with diabetes at 3 (OR 1.94, p = 0.036), 6 (OR 1.58, p = 0.117), and 12 (OR 1.47, p = 0.185) months. In patients with diabetes, (1) the opportunity of undergoing an arterial reconstruction is lower, (2) morbidity and mortality are higher, and (3) the quality of life tends to be worse.