Microvascular disease increases the risk of lower limb amputation - a Western Danish cohort study

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Standard

Microvascular disease increases the risk of lower limb amputation - a Western Danish cohort study. / Olesen, Kevin Kris Warnakula; Anand, Sonia; Thim, Troels et al.

In: European Journal of Clinical Investigation, Vol. 52, No. 10, e13812, 10.2022.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Harvard

APA

CBE

MLA

Vancouver

Author

Olesen, Kevin Kris Warnakula ; Anand, Sonia ; Thim, Troels et al. / Microvascular disease increases the risk of lower limb amputation - a Western Danish cohort study. In: European Journal of Clinical Investigation. 2022 ; Vol. 52, No. 10.

Bibtex

@article{f3b1dc4304fd4b69953eb88addb67978,
title = "Microvascular disease increases the risk of lower limb amputation - a Western Danish cohort study",
abstract = "BACKGROUND: Peripheral artery disease is the leading cause of non-traumatic lower limb amputation. Microvascular disease (MVD) increases the risk of lower limb amputation in patients with peripheral artery disease (PAD). We estimated risk of lower limb amputation associated with MVD and PAD in a Danish cohort.METHODS: We included every resident without previous lower limb amputation in Western Denmark aged 50-75 years on January 1, 2012 and followed them for 7 years. Participants were stratified by MVD and PAD. We estimated adjusted hazard ratios of lower limb amputation using individuals with no MVD and no PAD as reference. We also provide a sex-specific analyses and estimated the population attributable fraction of male sex.RESULTS: We included 933,597 individuals, of whom 16,741 had MVD only, 18,217 had PAD only, and 1,827 had MVD and PAD. Both MVD only (adjusted hazard ratio 3.36, 95% CI 2.98-3.73) and PAD only (adjusted hazard ratio 7.32, 95% CI 6.62-8.08) increased the risk of lower limb amputation separately. Individuals with MVD and PAD had the highest risk of amputation (adjusted hazard ratio 12.27, 95% CI 10.43-14.80). Men had increased absolute risk of amputation. Population attributable fraction associated with male sex was 31%.CONCLUSIONS: MVD and PAD are independently associated with a 3-fold and 7-fold increase of amputation risk, respectively. Combined, they had an additive effect constituting a 12-fold amputation risk. The amputation risk was higher in men than women, and 3 in 10 amputations were attributed to male sex.",
keywords = "amputation, cohort studies, microvascular disease, peripheral arterial disease, registries",
author = "Olesen, {Kevin Kris Warnakula} and Sonia Anand and Troels Thim and Christine Gyldenkerne and Michael Maeng",
year = "2022",
month = oct,
doi = "10.1111/eci.13812",
language = "English",
volume = "52",
journal = "European Journal of Clinical Investigation. Supplement",
issn = "0960-135X",
publisher = "Wiley-Blackwell Publishing Ltd.",
number = "10",

}

RIS

TY - JOUR

T1 - Microvascular disease increases the risk of lower limb amputation - a Western Danish cohort study

AU - Olesen, Kevin Kris Warnakula

AU - Anand, Sonia

AU - Thim, Troels

AU - Gyldenkerne, Christine

AU - Maeng, Michael

PY - 2022/10

Y1 - 2022/10

N2 - BACKGROUND: Peripheral artery disease is the leading cause of non-traumatic lower limb amputation. Microvascular disease (MVD) increases the risk of lower limb amputation in patients with peripheral artery disease (PAD). We estimated risk of lower limb amputation associated with MVD and PAD in a Danish cohort.METHODS: We included every resident without previous lower limb amputation in Western Denmark aged 50-75 years on January 1, 2012 and followed them for 7 years. Participants were stratified by MVD and PAD. We estimated adjusted hazard ratios of lower limb amputation using individuals with no MVD and no PAD as reference. We also provide a sex-specific analyses and estimated the population attributable fraction of male sex.RESULTS: We included 933,597 individuals, of whom 16,741 had MVD only, 18,217 had PAD only, and 1,827 had MVD and PAD. Both MVD only (adjusted hazard ratio 3.36, 95% CI 2.98-3.73) and PAD only (adjusted hazard ratio 7.32, 95% CI 6.62-8.08) increased the risk of lower limb amputation separately. Individuals with MVD and PAD had the highest risk of amputation (adjusted hazard ratio 12.27, 95% CI 10.43-14.80). Men had increased absolute risk of amputation. Population attributable fraction associated with male sex was 31%.CONCLUSIONS: MVD and PAD are independently associated with a 3-fold and 7-fold increase of amputation risk, respectively. Combined, they had an additive effect constituting a 12-fold amputation risk. The amputation risk was higher in men than women, and 3 in 10 amputations were attributed to male sex.

AB - BACKGROUND: Peripheral artery disease is the leading cause of non-traumatic lower limb amputation. Microvascular disease (MVD) increases the risk of lower limb amputation in patients with peripheral artery disease (PAD). We estimated risk of lower limb amputation associated with MVD and PAD in a Danish cohort.METHODS: We included every resident without previous lower limb amputation in Western Denmark aged 50-75 years on January 1, 2012 and followed them for 7 years. Participants were stratified by MVD and PAD. We estimated adjusted hazard ratios of lower limb amputation using individuals with no MVD and no PAD as reference. We also provide a sex-specific analyses and estimated the population attributable fraction of male sex.RESULTS: We included 933,597 individuals, of whom 16,741 had MVD only, 18,217 had PAD only, and 1,827 had MVD and PAD. Both MVD only (adjusted hazard ratio 3.36, 95% CI 2.98-3.73) and PAD only (adjusted hazard ratio 7.32, 95% CI 6.62-8.08) increased the risk of lower limb amputation separately. Individuals with MVD and PAD had the highest risk of amputation (adjusted hazard ratio 12.27, 95% CI 10.43-14.80). Men had increased absolute risk of amputation. Population attributable fraction associated with male sex was 31%.CONCLUSIONS: MVD and PAD are independently associated with a 3-fold and 7-fold increase of amputation risk, respectively. Combined, they had an additive effect constituting a 12-fold amputation risk. The amputation risk was higher in men than women, and 3 in 10 amputations were attributed to male sex.

KW - amputation

KW - cohort studies

KW - microvascular disease

KW - peripheral arterial disease

KW - registries

UR - http://www.scopus.com/inward/record.url?scp=85130719071&partnerID=8YFLogxK

U2 - 10.1111/eci.13812

DO - 10.1111/eci.13812

M3 - Journal article

C2 - 35534928

VL - 52

JO - European Journal of Clinical Investigation. Supplement

JF - European Journal of Clinical Investigation. Supplement

SN - 0960-135X

IS - 10

M1 - e13812

ER -