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Minor amputation does not negatively affect health‐related quality of life as compared with conservative treatment in patients with a diabetic foot ulcer: An observational study
Author(s) -
Pickwell K.,
Siersma V.,
Kars M.,
Apelqvist J.,
Bakker K.,
Edmonds M.,
Holstein P.,
Jirkovská A.,
Jude E.B.,
Mauricio D.,
Piaggesi A.,
Reike H.,
Spraul M.,
Uccioli L.,
Urbancic V.,
Acker K.,
Baal J.,
Schaper N.
Publication year - 2017
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2867
Subject(s) - observational study , amputation , medicine , quality of life (healthcare) , affect (linguistics) , diabetic foot , conservative treatment , foot (prosody) , physical therapy , diabetic foot ulcer , physical medicine and rehabilitation , diabetes mellitus , intensive care medicine , surgery , psychology , nursing , endocrinology , linguistics , philosophy , communication
Background Health‐related quality of life (HRQoL) is poor in patients with persistent diabetic foot ulcers and poor HRQoL predicts worse outcomes in these patients. Amputation is often considered a treatment failure, which is why conservative treatment is generally preferred over amputation. However, it is unclear whether minor amputation negatively affects HRQoL compared with conservative treatment in patients with diabetic foot ulcers. Methods In the cohort of the multicenter, prospective, observational Eurodiale study, we determined difference in change of HRQoL measured by EQ‐5D between patients with a diabetic foot ulcers that healed after conservative treatment (n = 676) and after minor amputation (n = 145). Propensity score was used to adjust for known confounders, attempting to overcome lack of randomization. Results Baseline HRQoL was not significantly different between patients treated conservatively and undergoing minor amputation. In addition, there was no difference in the change of HRQoL between these groups. In patients who healed 6 to 12 months after the first visit, HRQoL on the anxiety/depression subscale even appeared to improve more in those who underwent minor amputation. Conclusions Minor amputation was not associated with a negative impact on HRQoL in patients with a diabetic foot ulcers. It may therefore not be considered treatment failure in terms of HRQoL but rather a viable treatment option. A randomized controlled trial is warranted to further examine the influence of minor amputations on health‐related quality of life.