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

Abstract

Objective: 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. Design: A prospective study of patients with the first episode of ischaemia. Setting: University tertiary referral centre. Methods: Thirty-seven patients with diabetes and 50 without diabetes, were studied over a 12 month period with complete follow-up. Main outcome measures: The proportion of patients undergoing an arterial reconstruction, amputation rate, death rate, and quality-of-life scores. Results: 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. Conclusions: 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. © 1995 W. B. Saunders Company Ltd. All rights reserved.