Clinical frailty scale as a tool to predict outcomes after lower extremity amputation among patients with diabetes: A retrospective cohort study

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2025-05-20 DOI:10.1016/j.jdiacomp.2025.109084

Hilma Tillqvist , Miska Vuorlaakso , Mika Helminen , Juha Kiiski , Ilkka Kaartinen

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引用次数: 0

Abstract

Aims

The primary aim of this study was to investigate how the Clinical Frailty Scale (CFS) associates with survival of patients with diabetes after lower extremity amputation (LEA).

Methods

This retrospective cohort study included patients with diabetes undergoing nontraumatic LEA at Tampere University Hospital during 2007–2020. Kaplan-Meier and Cox regression analyses were performed to evaluate the effect of CFS on overall survival (OS), amputation-free survival (AFS) and leg salvage (LS).

Results

A total of 1043 patients with mean age 71.0 years were included. Compared to patients with low CFS (1, 2), scores 3–4 and 5–9 were associated with reduced OS (HR 1.821, p < 0.001; HR 4.585, p < 0.001), AFS (HR 1.575, p < 0.001; HR 4.031, p < 0.001) and LS (HR 1.435, p = 0.049; HR 2.478, p < 0.001). The multivariable Cox regression analysis showed that CFS remained a significant predictor of OS, AFS and LS.

Conclusions

This study demonstrates a high prevalence of frailty among patients with diabetes undergoing LEA, suggesting that frailty assessment should be integrated into clinical decision-making for this patient population. The CFS score appears to be a promising tool for evaluating patients facing amputation to enhance survival rates.

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临床虚弱量表作为预测糖尿病患者下肢截肢后预后的工具：一项回顾性队列研究

目的本研究的主要目的是探讨临床虚弱量表（CFS）与糖尿病患者下肢截肢（LEA）后生存的关系。方法本回顾性队列研究纳入2007-2020年坦佩雷大学医院接受非创伤性LEA治疗的糖尿病患者。采用Kaplan-Meier和Cox回归分析评估CFS对总生存期（OS）、无截肢生存期（AFS）和残肢保留期（LS）的影响。结果共纳入1043例患者，平均年龄71.0岁。与低CFS患者相比（1,2），3-4分和5-9分与OS降低相关(HR 1.821, p <；0.001;HR 4.585, p <；0.001), AFS (HR 1.575, p <；0.001;HR 4.031, p <；0.001)和LS (HR 1.435, p = 0.049；HR 2.478, p <；0.001)。多变量Cox回归分析显示，CFS仍然是OS、AFS和LS的显著预测因子。结论：本研究表明，在接受LEA治疗的糖尿病患者中，虚弱的患病率很高，提示应将虚弱评估纳入该患者群体的临床决策中。CFS评分似乎是评估面临截肢的患者以提高生存率的一个有前途的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.