Comorbid depression and risk of lower extremity amputation in people with diabetes: systematic review and metaanalysis

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dc.contributor.authorO'Neill, Sinéad M.
dc.contributor.authorKabir, Zubair
dc.contributor.authorMcNamara, Grace
dc.contributor.authorBuckley, Claire M.
dc.contributor.funderHealth Research Board
dc.date.accessioned2017-10-18T09:40:11Z
dc.date.available2017-10-18T09:40:11Z
dc.date.issued2017
dc.description.abstractObjective: To compare the risk of lower extremity amputation (LEA) in people with diabetes with and without comorbid depression. Research design and methods: A systematic review of the published literature was conducted. Six databases were searched including PubMed, CINAHL, EMBASE, Medline, the Cochrane Library and PsycARTICLES from inception to 22 June 2016, using a detailed search strategy and cross-checking of reference lists for potentially eligible studies published in English. No date restrictions were employed. All studies were reviewed independently for inclusion by two review authors. Data extraction was performed using a standardized data abstraction form, and study quality was assessed independently by two reviewers. A meta-analysis was performed reporting pooled hazard ratios (HRs) and 95% CIs in Review Manager software. Results: In total, seven studies were eligible for inclusion in the systematic review. Data on 767 997 patients from five studies were included in the meta-analysis. Pooled estimates across the studies were obtained using a random-effects model due to significant heterogeneity (I2=87%). People with diabetes and depression had an increased hazard of LEA (HR 1.76, 95% CI 1.19 to 2.60) compared to people with diabetes and no depression. Conclusions: Based on the available evidence, comorbid depression appears to increase the risk of LEA in people with diabetes. Limited data were available, however, with significant heterogeneity between studies. Further research is needed to inform intervention and clinical practice development in the management of diabetes.en
dc.description.sponsorshipHealth Research Board (Interdisciplinary Capacity Enhancement Award ICE/2012/12 ‘ Lifestyle Transitions and Trajectories through the Lifecourse: Enhancing capacity in Irish cohort and cross-sectional studies’)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide000366
dc.identifier.citationO’Neill, S. M., Kabir, Z., McNamara, G. and Buckley, C. M. (2017) 'Comorbid depression and risk of lower extremity amputation in people with diabetes: systematic review and meta-analysis', BMJ Open Diabetes Research and Care, 5(1), e000366 (11pp). doi: 10.1136/ bmjdrc-2016-000366en
dc.identifier.doi10.1136/ bmjdrc-2016-000366
dc.identifier.endpage11
dc.identifier.issn2052-4897
dc.identifier.journaltitleBMJ Open Diabetes Research and Careen
dc.identifier.startpage1
dc.identifier.urihttps://hdl.handle.net/10468/4873
dc.identifier.volume5
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.relation.urihttp://drc.bmj.com/content/5/1/e000366
dc.rights© 2017, Article authors or their employer(s) unless otherwise stated in the text of the article. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/en
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectComorbid depressionen
dc.subjectLower extremity amputationen
dc.subjectLEAen
dc.subjectDiabetesen
dc.titleComorbid depression and risk of lower extremity amputation in people with diabetes: systematic review and metaanalysisen
dc.typeReviewen
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