The impact of gender on diabetes-related lower extremity amputations: An Italian regional analysis on trends and predictors

Background: Diabetes-related lower extremity amputations (LEAs) are a major public health issue. The aim of the study was to evaluate trends by gender and predictors of LEAs in an Italian region. Methods: Data were collected from hospital discharge records between 2006 and 2015. Gender- and age-adjusted standardised hospitalisation rates for major and minor amputations were calculated. Poisson regression model was performed to estimate trends in LEAs. Results: Hospitalisation rates decreased for minor amputations both among males (-30.0%) and females (-5.3%), while the major amputation rates decreased only for males (-44.7%). Males were at higher risk of undergoing major (IRR 1.41, 95%Cl 1.19-1.67) and minor (IRR 1.62, 95%Cl 1.45-1.82) amputations. Peripheral vascular disease was the leading predictor of major and minor amputations. Conclusion: A significant reduction of LEAs was observed only for males. Identifying their predictable factors may help caregivers to provide higher standards of diabetes care. (C) 2020 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.