Study highlights link between socioeconomic deprivation and amputation risk

A new study has found the likelihood of amputations relating to diabetic foot disease is “inversely proportional” to the index of multiple deprivation.

The research, Socioeconomic Deprivation as a Predictor of Lower Limb Amputation in Diabetic Foot Disease, was carried out by a team from the orthopaedics and traumatology department at Wythenshawe Hospital in Manchester and the Faculty of Medicine at the University of Manchester.

They analysed data on patients admitted to the multidisciplinary unit with diabetic foot disease (DFD) over a five-year period, analysing the relationship between deprivation and outcomes in DFD.

They classified patients using the Index of Multiple Deprivation (IMD), which is a measure of relative social deprivation. This index classifies England into small subsets called lower layer super output areas (LSOAs) and then ranks these LSOAs into deciles from the most deprived to the least deprived area.

Postal codes were used to classify patients into IMD deciles, with decile 1 representing the 10 per cent of most deprived LSOAs and decile 10 the least deprived areas in the country.

The research team said: “We used this classification to analyse the relationship between deprivation and its influence on surgical outcomes and lower limb amputation. We specifically compared those falling in the top five against the bottom five deciles.”

The cohort consisted of 70 patients with diabetes who had surgery on their diabetic foot. Of this cohort, 33 (47 per cent) of these underwent amputation. The majority of these procedures were minor amputations conducted on the forefoot (75.6 per cent) and there were no below knee amputations.

Of those requiring an amputation, 27 patients (81.8 per cent) had an IMD decile of five or below, and only six (18.2 per cent) patients had above 5.

The study authors concluded: “Our study shows that the likelihood of amputations related to diabetic foot disease is inversely proportional to the index of multiple deprivation.”

Read the study in full here.

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