Your browser doesn't support javascript.
loading
The relationship of regional hemoglobin A1c testing and amputation rate among patients with diabetes.
Newhall, Karina A; Bekelis, Kimon; Suckow, Bjoern D; Gottlieb, Daniel J; Farber, Adrienne E; Goodney, Philip P; Skinner, Jonathan S.
Afiliación
  • Newhall KA; 1 Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.
  • Bekelis K; 2 VA Outcomes Group, White River Junction Veterans Hospital, White River Junction, VT, USA.
  • Suckow BD; 3 Section of Neurosurgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.
  • Gottlieb DJ; 4 Section of Vascular Surgery, Dartmouth Hitchock Medical Center, Lebanon, NH, USA.
  • Farber AE; 5 The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA.
  • Goodney PP; 5 The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA.
  • Skinner JS; 2 VA Outcomes Group, White River Junction Veterans Hospital, White River Junction, VT, USA.
Vascular ; 25(2): 142-148, 2017 Apr.
Article en En | MEDLINE | ID: mdl-27206471
ABSTRACT
Objective The risk of leg amputation among patients with diabetes has declined over the past decade, while use of preventative measures-such as hemoglobin A1c monitoring-has increased. However, the relationship between hemoglobin A1c testing and amputation risk remains unclear. Methods We examined annual rates of hemoglobin A1c testing and major leg amputation among Medicare patients with diabetes from 2003 to 2012 across 306 hospital referral regions. We created linear regression models to study associations between hemoglobin A1c testing and lower extremity amputation. Results From 2003 to 2012, the proportion of patients who received hemoglobin A1c testing increased 10% (74% to 84%), while their rate of lower extremity amputation decreased 50% (430 to 232/100,000 beneficiaries). Regional hemoglobin A1c testing weakly correlated with crude amputation rate in both years (2003 R = -0.20, 2012 R = -0.21), and further weakened with adjustment for age, sex, and disability status (2003 R = -0.11, 2012 R = -0.17). In a multivariable model of 2012 amputation rates, hemoglobin A1c testing was not a significant predictor. Conclusion Lower extremity amputation among patients with diabetes nearly halved over the past decade but only weakly correlated with hemoglobin A1c testing throughout the study period. Better metrics are needed to understand the relationship between preventative care and amputation.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Hemoglobina Glucada / Extremidad Inferior / Angiopatías Diabéticas / Enfermedad Arterial Periférica / Amputación Quirúrgica Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Vascular Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Hemoglobina Glucada / Extremidad Inferior / Angiopatías Diabéticas / Enfermedad Arterial Periférica / Amputación Quirúrgica Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Vascular Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos