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Studien zu Inzidenzen von Amputationen bei Personen mit Diabetes

Methodische Aspekte

Studies on the incidence of amputations among persons with diabetes

Methodological aspects

  • Leitthema
  • Published:
Der Diabetologe Aims and scope

Zusammenfassung

Hintergrund

Amputationen der unteren Extremitäten sind eine schwerwiegende Komplikation des Diabetes mellitus und ein wichtiger Indikator der Versorgungsqualität beim diabetischen Fußsyndrom (DFS). Epidemiologische Studien wiesen große Unterschiede in der Amputationsinzidenz bei Menschen mit Diabetes auf.

Ziel

Beschreibung relevanter methodischer Aspekte beim Vergleich von Studien zur Inzidenz von Amputationen bei Personen mit Diabetes mellitus.

Material und Methoden

Die Besonderheiten der Studienpopulation, die Schätzung der diabetischen Risikopopulation, die Definition und Zählweise von Amputationen sowie das statistische Auswertungsverfahren sind wichtige methodische Aspekte, die bei der Interpretation der Studienergebnisse berücksichtigt werden müssen.

Ergebnisse

Die veröffentlichen Daten zeigen erhebliche Differenzen in den Inzidenzraten von Amputationen bei Diabetes: Die Gesamtamputationsinzidenz variiert von minimal 78 bis maximal 704/100.000 Personenjahre. Dabei reichen die Werte für Majoramputationen von 33–383 und die für Minoramputationen von 86–363/100.000 Personenjahre. Bei der Analyse von Zeittrends im Rahmen epidemiologischer Studien ist ausschließlich eine Reduktion der Majoramputationsinzidenz bei Personen mit Diabetes festzustellen, Studienergebnisse bezüglich des Trends der Amputationen insgesamt und der Minoramputationen sind widersprüchlich.

Diskussion

Die Variabilität von Studienergebnissen zur Inzidenz von Amputationen bei Personen mit Diabetes mellitus beruht häufig auf methodischen Unterschieden. Um die Vergleichbarkeit von Studienergebnissen zu ermöglichen, sollten einheitliche Standards für das Studiendesign und die Präsentation der Ergebnisse etabliert werden.

Abstract

Background

Lower extremity amputations (LEA) are a life-threatening chronic complication of diabetes mellitus and an important indicator of the quality of diabetic foot care. Epidemiological studies show large differences in the incidence of LEA among people with diabetes mellitus.

Objective

Description of relevant methodological aspects when comparing studies on the incidence of amputations in people with diabetes mellitus.

Materials and methods

Characteristics of the study population, estimation of a population at risk, definition and recording of LEA as well as statistical approaches are the important methodological aspects and should, therefore, be considered in the interpretation of study results.

Results

The published results demonstrated considerable variation in the incidence of LEA among people with diabetes mellitus: the incidence rate of any LEA ranged between 78 (minimum) and 704 (maximum) per 100,000 person–years. The incidence rate of major LEA ranged between 33 and 383 per 100,000 person–years and the incidence rate of minor LEA ranged between 86 and 363 per 100,000 person–years. The epidemiological studies showed a reduction concerning the incidence of a major LEA among people with diabetes over time. The current study results regarding time trends for any LEA and minor LEA are contradictory.

Conclusions

The marked variations concerning the incidence of LEA among people with diabetes are often due to methodological differences. It is therefore desirable to establish uniform standards for study designs and reporting of the results.

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Authors and Affiliations

  1. Institut für Versorgungsforschung und Gesundheitsökonomie, Deutsches Diabetes-Zentrum, Deutsche Diabetes Forschungsgesellschaft e. V., Leibniz-Zentrum für Diabetes-Forschung an der Heinrich-Heine-Universität Düsseldorf, 40225, Düsseldorf, Deutschland

    Maria Narres MscPH, Tatjana Kvitkina, Heiner Claessen, Stephan Morbach & Andrea Icks

  2. Institut für Versorgungsforschung und Gesundheitsökonomie, Centre for Health and Society, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland

    Andrea Icks

  3. Marienkrankenhaus gGmbH Soest, Soest, Deutschland

    Stephan Morbach

  4. Gefäßzentrum Oberrhein, Klinik für Gefäßchirurgie, Diakonissen Speyer-Mannheim, Diakonissen-Stiftungs-Krankenhaus Speyer, Speyer, Deutschland

    Gerhard Rümenapf

  5. Deutsches Zentrum für Diabetesforschung e. V., 85764, Neuherberg, Deutschland

    Andrea Icks

Authors
  1. Maria Narres MscPH
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  2. Tatjana Kvitkina
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  3. Heiner Claessen
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  4. Stephan Morbach
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  5. Gerhard Rümenapf
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  6. Andrea Icks
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Corresponding author

Correspondence to Maria Narres MscPH.

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Interessenkonflikt

M. Narres, T. Kvitkina, H. Claessen, S. Morbach, G. Rümenapf und A. Icks geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Narres, M., Kvitkina, T., Claessen, H. et al. Studien zu Inzidenzen von Amputationen bei Personen mit Diabetes. Diabetologe 15, 217–222 (2019). https://doi.org/10.1007/s11428-019-0445-0

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