<- Home <- Arhive <- Vol. 26, Issue 4, December 2018

Rom J Leg Med26(4)441-446(2018)
© Romanian Society of Legal Medicine

Nontraumatic upper and lower-extremity amputation, an incidence-based Disability-Adjusted Life Years (DALY) approach

I. R. Toma, C. Precup, T. Olariu, V. Toma, I. Olariu, D. G. Negru, E. D. Popovici, M. Marian, C. F. Ifrim

Abstract: The aim was to estimate the odds ratio and burden of disease from nontraumatic upper and lower-extremity amputations attributable to diabetes and skin disorders in Arad County, Romania, from 2014 to 2018. A descriptive epidemiological study was chosen by calculating disability-adjusted life years (DALY). Odds ratio for amputations in diabetic patients was 21.7545 (95% CI 10,2969 to 45,9614; P < 0,0001) compared to non-diabetics ones. Burden of disease was high, 1,962 DALY in men and women, double for men compared to women, in cases with deaths related to amputation; burden of disease related with death caused by the main medical condition, mainly diabetes, was 21,964 DALY, with comparable Years Lost due to Disability (YLD) in men and women but with YLD component in women pushing this rate to 51.59% of total DALY, while in men represents 42.02%, meaning that women with diabetes in Arad are aging as diabetic ones and amputees more often than men. The burden of disease has to be evaluated every year and public health strategies must be tailored for improving glycemia control and avoid diabetic foot complications in all vulnerable patients. Considering that almost 30,000 people in Arad County live with diabetes, with a five years hospital admissions of 21.45% of them and 696 amputations (10.81%), even if only 2,75% of the patients died during the index hospitalization, the burden of disease has to be evaluated every year and all strategies for prevention and health education for diabetic foot should be oriented according to vulnerability of these patients.
Keywords: amputation, diabetes, Years Lost due to Disability.

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