Diabetes‐Associated Major Limb Amputation in Solomon Islands: A National, 5‐Year Retrospective Study
Notice bibliographique
Résumé
BACKGROUND: Solomon Islands is a Western Pacific nation with one of the highest diabetes prevalences in the world. The delivery of surgical care is challenging given the country's complex geography and limited healthcare resources. This retrospective study aims to quantify diabetes-associated major limb amputation and to describe the characteristics of patients undergoing this procedure. METHODS: Demographic, clinical, and surgical data were abstracted for patients who underwent major limb amputation secondary to diabetic infection. Summary statistics were gathered from this dataset. Additionally, patients' village names were abstracted, located from publicly available data, and mapped using ArcPro software. The geodesic distance between villages and the surgical centers performing amputation was calculated. Univariate and multivariate modeling was employed to assess the relationship between an a priori set of variables and several outcomes. RESULTS: Over a 5-year period (2018-2023), 401 amputations were performed on 356 patients with diabetic limb infections. Three hundred and five patients had medical records available for abstraction. The median age was 55 (range: 22-84 years), and 160 were male (52.5%). Trauma was the most common cause of ulceration (N = 135, 44.3%). Delayed presentation was common with 100 patients (32.8%) presenting more than 30 days after symptom onset. The mean Wagner score on presentation was 3.6 (STD: 0.8, range: 2-5). Most patients (N = 293, 96%) experienced surgical delays. Among all patients who underwent major limb amputation, 38 (10.7%) died prior to discharge. The mean linear distance between patient villages and surgical centers was 53.6 km. Greater distance was associated with more delayed presentation (Correlation Coeff: 0.14, p = 0.03) and higher Wagner scores (Kruskal-Wallis statistic: 10.7, p = 0.01). Multivariable logistic regression indicated that males were more likely to undergo above-knee amputation as compared to females (OR: 2.13, p = 0.009). Further multivariable modeling demonstrated that male sex was correlated with higher wait times from presentation to amputation (p = 0.035). CONCLUSION: Major limb amputation is a costly and radical procedure which contributes to severe disability in the local context. Upstream interventions to manage diabetes and facilitate access to surgical care are likely to prevent limb loss.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».