Evidence map›Paper›PMID 34404707›Full record

ArticleBMJ open2021

Incidence of lower limb amputation in people with and without diabetes: a nationwide 5-year cohort study in Japan.

Fumika Kamitani, Yuichi Nishioka, Tatsuya Noda, Tomoya Myojin, Shinichiro Kubo, Tsuneyuki Higashino, Sadanori Okada, Yasuhiro Akai, Hitoshi Ishii, Yutaka Takahashi and 1 more

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Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Fumika KamitaniDepartment of Diabetes and Endocrinology, Nara Medical University, Kashihara, Nara, Japan.
Yuichi NishiokaDepartment of Diabetes and Endocrinology, Nara Medical University, Kashihara, Nara, Japan.
Tatsuya NodaDepartment of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Nara, Japan noda@naramed-u.ac.jp.ORCID 0000-0002-3652-7547
Tomoya MyojinDepartment of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Nara, Japan.
Shinichiro KuboDepartment of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Nara, Japan.
Tsuneyuki HigashinoHealthcare and Wellness Division, Mitsubishi Research Institute, Inc, Tokyo, Japan.
Sadanori OkadaDepartment of Diabetes and Endocrinology, Nara Medical University, Kashihara, Nara, Japan.
Yasuhiro AkaiDepartment of Diabetes and Endocrinology, Nara Medical University, Kashihara, Nara, Japan.
Hitoshi IshiiDepartment of Diabetes and Endocrinology, Nara Medical University, Kashihara, Nara, Japan.
Yutaka TakahashiDepartment of Diabetes and Endocrinology, Nara Medical University, Kashihara, Nara, Japan.
Tomoaki ImamuraDepartment of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Nara, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study was conducted to investigate the incidence and time trend of lower limb amputation (LLA) among people with and without diabetes. RESEARCH DESIGN AND

methodsThis retrospective population-based cohort study was based on the national claims data in Japan, comprising a total population of 150 million. Data of all individuals who had LLA from April 2013 to March 2018 were obtained. We analysed the sex-adjusted and age-adjusted annual LLA rate (every fiscal year) in people with and without diabetes for major and minor amputation. To test for time trend, Poisson regression models were fitted.

resultsIn the 5-year period, 30 187 major and 29 299 minor LLAs were performed in Japan. The sex-adjusted and age-adjusted incidence of major and minor LLAs was 9.5 (people with diabetes, 21.8 vs people without diabetes, 2.3, per 100 000 person-years) and 14.9 (people with diabetes, 28.4 vs people without diabetes, 1.9, per 100 000 person-years) times higher, respectively, in people with diabetes compared with those without. A significant decline in the annual major amputation rate was observed (p<0.05) and the annual minor amputation rate remained stable (p=0.63) when sex, age and people with and without diabetes were included as dependent variables.

conclusionsThis is the first report of the national statistics of LLAs in Japan. The incidence of major and minor LLAs was 10 and 15 times higher, respectively, in people with diabetes compared with those without. A significant decline in the major amputation rate was observed, and the annual minor amputation rate remained stable during the observation period. This information can help to create an effective national healthcare strategy for preventing limb amputations, which affect the quality of life of patients with diabetes and add to the national healthcare expenditure.

Indexed as

Diabetes MellitusQuality of LifeAmputation, SurgicalCohort StudiesHumansIncidenceJapanLower ExtremityRetrospective Studiesdiabetes & endocrinologyepidemiologyorthopaedic & trauma surgery

Identifiers

PMID34404707
PMCPMC8372805

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.