Long-term mortality rates after lower extremity amputation in individuals with and without diabetes mellitus (DUDE-10): A retrospective matched cohort study

L. Rosien; H. J.G. Bilo; J. Oskam; D. Ruwaard; R. O.B. Gans; M. A. Edens; M. J. Molegraaf; P. R. van Dijk

doi:10.1016/j.jdiacomp.2025.108956

Long-term mortality rates after lower extremity amputation in individuals with and without diabetes mellitus (DUDE-10): A retrospective matched cohort study

L. Rosien^*, H. J.G. Bilo, J. Oskam, D. Ruwaard, R. O.B. Gans, M. A. Edens, M. J. Molegraaf, P. R. van Dijk

^*Corresponding author for this work

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Abstract

Background/objectives: To determine mortality rates after lower extremity amputation (LEA) in individuals with and without diabetes mellitus (DM).

Methods: Retrospective, observational study using data from a database covering >99 % of the Dutch population. LEAs in 2016 were identified, and mortality data from 2016 to 2021 were analyzed. Study group 1 (SG1) included individuals with DM and LEA (DM+/LEA+) with two control groups (CG), DM+/LEA− (matched by age, sex, without (1a) and with (1b) socioeconomic status matching). Study group 2 (SG2) (DM+/LEA+) was composed after matching with non-DM individuals with LEA (DM−/LEA+ (2a)).

Results: Among 5145 individuals with LEA in 2016, 56 % had DM. Five-year mortality was 61.2 % in SG1 (DM+/LEA+) and 27.9 % in CG1a (DM+, LEA−) and 1b. Study group 2 (DM+/LEA+) had a 62.6 % five-year mortality rate, compared to 56.4 % in CG2a (DM−/LEA+).

Conclusions: Mortality after LEA is high, especially in DM; socioeconomic status (SES) does not significantly impact mortality.

Level of evidence: Level III retrospective cohort study.

Original language	English
Article number	108956
Number of pages	7
Journal	Journal of Diabetes and its Complications
Volume	39
Issue number	3
DOIs	https://doi.org/10.1016/j.jdiacomp.2025.108956
Publication status	Published - Mar-2025

Keywords

Diabetes mellitus
Lower extremity amputation
Mortality

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Rosien, L., Bilo, H. J. G., Oskam, J., Ruwaard, D., Gans, R. O. B., Edens, M. A., Molegraaf, M. J., & van Dijk, P. R. (2025). Long-term mortality rates after lower extremity amputation in individuals with and without diabetes mellitus (DUDE-10): A retrospective matched cohort study. Journal of Diabetes and its Complications, 39(3), Article 108956. https://doi.org/10.1016/j.jdiacomp.2025.108956

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title = "Long-term mortality rates after lower extremity amputation in individuals with and without diabetes mellitus (DUDE-10): A retrospective matched cohort study",

abstract = "Background/objectives: To determine mortality rates after lower extremity amputation (LEA) in individuals with and without diabetes mellitus (DM).Methods: Retrospective, observational study using data from a database covering >99 % of the Dutch population. LEAs in 2016 were identified, and mortality data from 2016 to 2021 were analyzed. Study group 1 (SG1) included individuals with DM and LEA (DM+/LEA+) with two control groups (CG), DM+/LEA− (matched by age, sex, without (1a) and with (1b) socioeconomic status matching). Study group 2 (SG2) (DM+/LEA+) was composed after matching with non-DM individuals with LEA (DM−/LEA+ (2a)).Results: Among 5145 individuals with LEA in 2016, 56 % had DM. Five-year mortality was 61.2 % in SG1 (DM+/LEA+) and 27.9 % in CG1a (DM+, LEA−) and 1b. Study group 2 (DM+/LEA+) had a 62.6 % five-year mortality rate, compared to 56.4 % in CG2a (DM−/LEA+).Conclusions: Mortality after LEA is high, especially in DM; socioeconomic status (SES) does not significantly impact mortality.Level of evidence: Level III retrospective cohort study.",

keywords = "Diabetes mellitus, Lower extremity amputation, Mortality",

author = "L. Rosien and Bilo, {H. J.G.} and J. Oskam and D. Ruwaard and Gans, {R. O.B.} and Edens, {M. A.} and Molegraaf, {M. J.} and {van Dijk}, {P. R.}",

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year = "2025",

month = mar,

doi = "10.1016/j.jdiacomp.2025.108956",

language = "English",

volume = "39",

journal = "Journal of Diabetes and its Complications",

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Rosien, L , Bilo, HJG, Oskam, J, Ruwaard, D, Gans, ROB, Edens, MA, Molegraaf, MJ & van Dijk, PR 2025, 'Long-term mortality rates after lower extremity amputation in individuals with and without diabetes mellitus (DUDE-10): A retrospective matched cohort study', Journal of Diabetes and its Complications, vol. 39, no. 3, 108956. https://doi.org/10.1016/j.jdiacomp.2025.108956

TY - JOUR

T1 - Long-term mortality rates after lower extremity amputation in individuals with and without diabetes mellitus (DUDE-10)

T2 - A retrospective matched cohort study

AU - Rosien, L.

AU - Bilo, H. J.G.

AU - Oskam, J.

AU - Ruwaard, D.

AU - Gans, R. O.B.

AU - Edens, M. A.

AU - Molegraaf, M. J.

AU - van Dijk, P. R.

PY - 2025/3

Y1 - 2025/3

N2 - Background/objectives: To determine mortality rates after lower extremity amputation (LEA) in individuals with and without diabetes mellitus (DM).Methods: Retrospective, observational study using data from a database covering >99 % of the Dutch population. LEAs in 2016 were identified, and mortality data from 2016 to 2021 were analyzed. Study group 1 (SG1) included individuals with DM and LEA (DM+/LEA+) with two control groups (CG), DM+/LEA− (matched by age, sex, without (1a) and with (1b) socioeconomic status matching). Study group 2 (SG2) (DM+/LEA+) was composed after matching with non-DM individuals with LEA (DM−/LEA+ (2a)).Results: Among 5145 individuals with LEA in 2016, 56 % had DM. Five-year mortality was 61.2 % in SG1 (DM+/LEA+) and 27.9 % in CG1a (DM+, LEA−) and 1b. Study group 2 (DM+/LEA+) had a 62.6 % five-year mortality rate, compared to 56.4 % in CG2a (DM−/LEA+).Conclusions: Mortality after LEA is high, especially in DM; socioeconomic status (SES) does not significantly impact mortality.Level of evidence: Level III retrospective cohort study.

AB - Background/objectives: To determine mortality rates after lower extremity amputation (LEA) in individuals with and without diabetes mellitus (DM).Methods: Retrospective, observational study using data from a database covering >99 % of the Dutch population. LEAs in 2016 were identified, and mortality data from 2016 to 2021 were analyzed. Study group 1 (SG1) included individuals with DM and LEA (DM+/LEA+) with two control groups (CG), DM+/LEA− (matched by age, sex, without (1a) and with (1b) socioeconomic status matching). Study group 2 (SG2) (DM+/LEA+) was composed after matching with non-DM individuals with LEA (DM−/LEA+ (2a)).Results: Among 5145 individuals with LEA in 2016, 56 % had DM. Five-year mortality was 61.2 % in SG1 (DM+/LEA+) and 27.9 % in CG1a (DM+, LEA−) and 1b. Study group 2 (DM+/LEA+) had a 62.6 % five-year mortality rate, compared to 56.4 % in CG2a (DM−/LEA+).Conclusions: Mortality after LEA is high, especially in DM; socioeconomic status (SES) does not significantly impact mortality.Level of evidence: Level III retrospective cohort study.

KW - Diabetes mellitus

KW - Lower extremity amputation

KW - Mortality

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U2 - 10.1016/j.jdiacomp.2025.108956

DO - 10.1016/j.jdiacomp.2025.108956

M3 - Article

AN - SCOPUS:85216769642

SN - 1056-8727

VL - 39

JO - Journal of Diabetes and its Complications

JF - Journal of Diabetes and its Complications

IS - 3

M1 - 108956

ER -

Long-term mortality rates after lower extremity amputation in individuals with and without diabetes mellitus (DUDE-10): A retrospective matched cohort study

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