Introduction: Type 2 diabetes continues to be one of the most common and costly conditions in the United States. Complications and co-morbidities that develop, such as amputations, add to the financial toll and can reduce the life expectancy of these individuals. The aim of this study was to identify risk factors that lead to early mortality (12 months or less) following subacute inpatient, interdisciplinary rehabilitation at a VA Community Living Center (CLC).
Methods: A retrospective medical chart review was conducted on forty-seven Veterans who had a lower extremity amputation and died between 2015-2018. Demographic variables collected included age, months between discharge and death, and social support at home. Conditions on status of hypertension, type 2 diabetes, coronary artery disease, congestive heart failure, smoking status, end-stage renal disease and chronic renal disease were gathered at date of death.
Results: The mean age at CLC admission was 68 years and the average time of death was 14.2 months after discharge. It was shown that 50.5% of the patients returned home to social support. Mean HbA1c was 7.1% prior to amputation. A multiple logistic regression was performed associating status of persons with type 2 diabetes (P=.043, 95% CI = .09 - 5.25) and concurrent chronic renal disease (P=.02, 95% CI = .33 - 4.79) leading to death at less than 12 months. There was no significant relationship between hypertension, smoking, age, end-stage renal disease, congestive heart failure with mortality after discharge from the CLC. No association was found between pre-operative HbA1c status and survivorship.
Conclusion: There was a relationship between those who died within 12 months and diagnosis with both type 2 diabetes and chronic renal disease after an inpatient stay at a VA Community Living Center. These results suggest diabetes along with concurrent chronic renal disease management needs to be maintained after an inpatient stay to prevent premature death.
J. Chan: None. K. Yan: None.
