Epidemiological profile of hospitalizations and deaths due to amputations of limbs of people with Diabetes Mellitus in Alagoas – Brazil

Authors

DOI:

https://doi.org/10.33448/rsd-v10i10.19208

Keywords:

Amputation; Diabetic Foot; Disarticulation; Diabetes Mellitus; Diabetes Complications; Health Profile.

Abstract

This study aims to analyze the epidemiological profile of hospitalizations and deaths due to amputations of limbs of people with Diabetes Mellitus in the State of Alagoas. Ecological time series study with data obtained from the SUS Department of Informatics - DATASUS, whose main outcome is the number of admissions for amputation of limbs and deaths of people with Diabetes Mellitus, between 2007 and 2018, with variables related to person, time, place and intervention. Descriptive analysis, association measures and respective 95% confidence intervals were performed. 636 cases of amputation with 39 deaths were analyzed. There was an increase in amputations from 2014 to 2016; the mean age was 64 years of age with a range from one to 98 years. The lower limb amputation rate averaged 61%. Males present with a relative risk 37% higher risk of amputation due to diabetes than females and 101% of deaths. There is an 80% higher relative risk of death from amputation in the elderly than in non-elderly people. Actions by multiprofessional health teams in education, prevention and treatment programs fostering improved care interventions to prevent lower limb injuries can favor DM control by reducing amputations and deaths, as it is subject to monitoring, care and control that can be performed by primary health care.

References

Bal, B. S., Khanna, G., Bhardwaj, A., & Singh, K. (2019). Evaluation of risk factors for lower extremity amputation in diabetic foot ulcer: a hospital based observational study in Northern India. Int J Res Med Sci. 7(4), 1190-1195. http://dx.doi.org/10.18203/2320-6012.ijrms20191323.

Boing, A. F.; d’Orsi, E. & Reibnitz, C. (2021). Epidemiologia - Conceitos da Epidemiologia. https://unasus2.moodle.ufsc.br/pluginfile.php/33454/mod_resource/content/1/un1/pdf/creditos_m03_online.pdf.

Buckley, C. M., O'Farrell, A., Canavan, R. J., Lynch, A. D., De La Harpe, D.V., Bradley, C. P., & Perry, I. J. (2012). Trends in the Incidence of Lower Extremity Amputations in People with and without Diabetes over a Five-Year Period in the Republic of Ireland. Plos One. 7(7), e41492. https://doi.org/10.1371/journal.pone.0041492.

CONASS (2016). OMS classifica o Diabetes como epidemia mundial. Conselho Nacional de Secretários de Saúde (CONASS). https://www.conass.org.br/oms-classifica-o-diabetes-como-epidemia-mundial/.

Freire, M. C. M., & Pattussi, M. P. (2018). Tipos de estudos. In: C. Estrela (Org.). Metodologia Científica. Ciência, ensino e pesquisa. (3a. ed., pp. 109-127). Porto Alegre: Artes Médicas.

Graz, H., D'Souza, V. K., Alderson, D., & Graz, M. (2018). Diabetes-related amputations create considerable public health burden in the UK. Diabetes research and clinical practice, 135, 158–165. https://doi.org/10.1016/j.diabres.2017.10.030.

Henry, A. J., Hevelone, N. D., Hawkins, A. T., Watkins, M. T., Belkin, M., & Nguyen, L. L. (2013). Factors predicting resource utilization and survival after major amputation. Journal of vascular surgery, 57(3), 784–790. https://doi.org/10.1016/j.jvs.2012.09.035.

Herbert, R. (2013). Confidence Interval Calculator. https://pedro.org.au/portuguese/resources/confidence-interval-calculator/.

Hoffmann, F., Claessen, H., Morbach, S., Waldeyer, R., Glaeske, G., & Icks, A. (2013). Impact of diabetes on costs before and after major lower extremity amputations in Germany. Journal of diabetes and its complications, 27(5), 467–472. https://doi.org/10.1016/j.jdiacomp.2013.05.001.

IBGE (2019). Em 2019, expectativa de vida era de 76,6 anos. Instituto Brasileiro de Geografia e Estatística (IBGE). https://agenciadenoticias.ibge.gov.br/agencia-sala-de-imprensa/2013-agencia-de-noticias/releases/29502-em-2019-expectativa-de-vida-era-de-76-6-anos#:~:text=A%20expectativa%20de%20vida%20dos,2018%20(12%2C4).

IWGDF (2019). International Consensus on the Diabetic Foot & Practical and specific guidelines on the management and prevention of the diabetic foot. International Working Group on the Diabetic Foot (IWGDF). Brussels: IWGDF. https://iwgdfguidelines.org/wp-content/uploads/2019/05/IWGDF-Guidelines-2019.pdf.

Jesus-Silva, S. G., Oliveira, J. P., Brianezi, M. H. C., Silva, M. A. M., Krupa, A. E., & Cardoso, R. S. (2017). Analysis of risk factors related to minor and major lower limb amputations at a tertiary hospital. J Vasc Bras. 16(1), 16-22. https://doi.org/10.1590/1677-5449.008916.

Lin, C., Armstrong, D. G., Lin, C., Liu, P., Hung, S., Lee, S., …, Huang, Y. (2019). Nationwide trends in the epidemiology of diabetic foot complications and lower-extremity amputation over an 8-year period. BMJ Open Diabetes Research and Care. 7, e000795. https://doi: 10.1136 / bmjdrc-2019-000795.

Ministério da Saúde (2017). Secretaria de Atenção à Saúde. Departamento de Regulação, Avaliação e Controle. Coordenação Geral de Sistemas de Informação. SIH – Sistema de Informação Hospitalar do SUS: Manual Técnico Operacional do Sistema. http://www.saude.sp.gov.br/resources/ses/perfil/gestor/homepage/auditoria/manuais/manual_sih_janeiro_2017.pdf.

Ministério da Saúde (2016). Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Manual do pé diabético: estratégias para o cuidado da pessoa com doença crônica /Ministério da Saúde. http://189.28.128.100/dab/docs/portaldab/publicacoes/manual_do_pe_diabetico.pdf.

Nieto-Gil, P., Ortega-Avila, A. B., Pardo-Rios, M., Cobo-Najar, M., Blasco-Garcia, C., & Gijon-Nogueron, G. (2018). Hospitalisation Cost of Patients with Diabetic Foot Ulcers in Valencia (Spain) in the Period 2009-2013: A Retrospective Descriptive Analysis. International journal of environmental research and public health, 15(9), 1831. https://doi.org/10.3390/ijerph15091831.

Peek, M. E. (2011). Gender Differences in Diabetes-related Lower Extremity Amputations. Clinical Orthopaedics and Related Research, 469(7), 1951–1955. https://doi.org/10.1007/s11999-010-1735-4.

Peixoto, A. M., Zimpel, S. A., Oliveira, A. C. A., Monteiro, R. L. S., & Carneiro, T. K. G. (2017). Prevalence of upper and lower limb amputations of SUS patients in the state of Alagoas between 2008 and 2015. Fisioter Pesqui. 24(4), 378-384. https://doi:10.1590/1809-2950/17029524042017.

Rodrigues, F. F. L. (2015). Tendência de internações hospitalares de pacientes com e sem o diagnóstico de diabetes mellitus submetidos à amputação não traumática de extremidades inferiores, Ribeirão Preto - SP, 2001-2008. Tese de Doutorado, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto. doi:10.11606/T.22.2015.tde-29052015-192858. www.teses.usp.br.

Rolim, D., Sampaio, S., Gonçalves‐Dias, P., Almeida, P., Almeida‐Lopes, J., & Teixeira, J. F. (2015). Mortalidade depois da Amputação. Angiol Cir Vasc. 11(3), 166-170. https://doi.org/10.1016/j.ancv.2015.06.001

Rubio, J. A., Aragón-Sánchez, J., Jiménez, S., Guadalix, G., Albarracín, A., Salido, C., Sanz-Moreno, J., ..., Álvarez, J. (2014). Reducing major lower extremity amputations after the introduction of a multidisciplinary team for the diabetic foot. The International Journal of Lower Extremity Wounds, 13(1), 22-26. https://doi.org/10.1177/1534734614521234.

Santos, K. P. B., Luz, S. C. T., Mochizuki, L., & d'Orsi, E. (2018). Burden of disease from lower limb amputations attributable to diabetes mellitus in Santa Catarina State, Brazil, 2008-2013. Cad. Saúde Pública. 34(1), e00013116. https://doi.org/10.1590/0102-311X00013116.

Silva, R. S., Haddad, M. C. L., Rossaneis, M. A., & Marcos Fabrício Franco Gois, M. F. F. (2015). Análise financeira das internações de diabéticos submetidos à amputação de membros inferiores em hospital público. Ciências Biológicas e da Saúde, 36 (1), 81-88. doi:10.5433/1679-0367.2014v35n2p81

Toscano, C. M., Sugita, T. H., Rosa, M., Pedrosa, H. C., Rosa, R., & Bahia, L. R. (2018). Annual Direct Medical Costs of Diabetic Foot Disease in Brazil: A Cost of Illness Study. International journal of environmental research and public health, 15(1), 89. https://doi.org/10.3390/ijerph15010089.

Varma, P., Stineman, M. G., & Dillingham, T. R. (2014). Epidemiology of limb loss. Physical medicine and rehabilitation clinics of North America, 25(1), 1–8. https://doi.org/10.1016/j.pmr.2013.09.001.

Published

18/08/2021

How to Cite

SILVA, R. N. da; ALBUQUERQUE, R. de F. A. de; MAGALHÃES, P. K. A.; SANTOS, E. A. dos; TRINDADE, R. F. C. da; MALTA, J. M. A. S. .; NUNES, M. A. P.; SILVA, F. A. da. Epidemiological profile of hospitalizations and deaths due to amputations of limbs of people with Diabetes Mellitus in Alagoas – Brazil. Research, Society and Development, [S. l.], v. 10, n. 10, p. e546101019208, 2021. DOI: 10.33448/rsd-v10i10.19208. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/19208. Acesso em: 20 oct. 2021.

Issue

Section

Health Sciences