ABSTRACT
INTRODUCCIÓN: Analizar la influencia del nivel socioeconómico (NSE) sobre el perfil clínico del paciente amputado de miembro inferior por causa no traumática. MÉTODOS: Estudio retrospectivo con 697 pacientes amputados de miembro inferior, en un Servicio de Angiología y Cirugía Vascular, durante un periodo de 5 años. Los pacientes fueron divididos según NSE (bajo, medio y alto). Se analizaron variables demográficas (edad y género) y clínicas (causa, comorbilidad, factores de riesgo cardiovascular y nivel de amputación). RESULTADOS: La edad media fue 70,5 ± DE 11,9 años y la mediana 72 años. El NSE bajo presentó mayor frecuencia de hombres amputados. Todos los factores de riesgo cardiovascular fueron más frecuentes en este nivel, aunque solo fue estadísticamente significativo en diabetes (85,8% bajo, 69,3% medio, 65% alto; p < 0,01) y obesidad (31,4% bajo, 22,6% medio, 12,5% alto, p < 0,01). La retinopatía diabética fue la única comorbilidad que mostró asociación significativa con el NSE bajo (21,1% bajo, 15,3% medio, 12,5% alto, p < 0,03). No existió diferencia entre los NSE respecto de la causa de amputación. Se observó mayor frecuencia de amputación mayor en el NSE bajo, siendo esta diferencia estadísticamente significativa (63,6% bajo, 41,2% medio, 55% alto, p < 0,04) y una mayor predisposición a este nivel de amputación. CONCLUSIONES: El NSE bajo determina un perfil de riesgo vascular más desfavorable en los pacientes amputados de miembro inferior por causa no traumático y una mayor predisposición a sufrir amputación mayor. Este NSE muestra una influencia negativa sobre diabetes, obesidad y retinopatía diabética en estos pacientes
INTRODUCTION: To analyse the influence of socioeconomic status on the clinical profile of patients undergoing non-traumatic lower-limb amputation. METHODS: Retrospective study of 697 lower-limb amputee patients in an Angiology and Vascular Surgery Department during a 5-year period. Patients were classified according to their socioeconomic status (low, medium and high). We analysed demographic (age and gender) and clinical variables (cause of amputation, comorbidity, cardiovascular risk factors and amputation level). RESULTS: Mean age was 70.5 ± 11.9 years, and the median was 72 years. The low socioeconomic status group presented a higher frequency of amputations in men. Cardiovascular risks factors were more frequent in this socioeconomic group, and the difference was statistically significant for diabetes (85.8% low, 69.3% medium, 65% high; P < .01) and obesity (31.4% low, 22.6% medium, 12.5% high, P < .01). Diabetic retinopathy was the only comorbidity with a significant association with low socioeconomic status (21.1% low, 15.3% medium, 12.5% high, P < .03). Regarding the cause for amputation, there was no difference in terms of socioeconomic status. The low socioeconomic level showed a higher frequency of major amputation, which was a significant difference (63.6% low, 41.2% medium, 55% high, P < .04) and a higher predisposition for this amputation level. CONCLUSIONS: The low socioeconomic status has been shown to determine an unfavourable vascular risk profile in lower-limb non-traumatic amputees and a higher predisposition of a major amputation. This socioeconomic level demonstrates a negative influence on these patients' diabetes, obesity and diabetic retinopathy
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Amputation, Surgical/economics , Cost of Illness , Social Class , Lower Extremity/surgery , Socioeconomic Factors , Retrospective Studies , Risk Factors , Analysis of Variance , Cross-Sectional StudiesABSTRACT
INTRODUCTION: To analyse the influence of socioeconomic status on the clinical profile of patients undergoing non-traumatic lower-limb amputation. METHODS: Retrospective study of 697 lower-limb amputee patients in an Angiology and Vascular Surgery Department during a 5-year period. Patients were classified according to their socioeconomic status (low, medium and high). We analysed demographic (age and gender) and clinical variables (cause of amputation, comorbidity, cardiovascular risk factors and amputation level). RESULTS: Mean age was 70.5 ± 11.9 years, and the median was 72 years. The low socioeconomic status group presented a higher frequency of amputations in men. Cardiovascular risks factors were more frequent in this socioeconomic group, and the difference was statistically significant for diabetes (85.8% low, 69.3% medium, 65% high; P<.01) and obesity (31.4% low, 22.6% medium, 12.5% high, P<.01). Diabetic retinopathy was the only comorbidity with a significant association with low socioeconomic status (21.1% low, 15.3% medium, 12.5% high, P<.03). Regarding the cause for amputation, there was no difference in terms of socioeconomic status. The low socioeconomic level showed a higher frequency of major amputation, which was a significant difference (63.6% low, 41.2% medium, 55% high, P<.04) and a higher predisposition for this amputation level. CONCLUSIONS: The low socioeconomic status has been shown to determine an unfavourable vascular risk profile in lower-limb non-traumatic amputees and a higher predisposition of a major amputation. This socioeconomic level demonstrates a negative influence on these patients' diabetes, obesity and diabetic retinopathy.
