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, 28 (2), 32-7

Independent Risk Factors for Amputation in Diabetic Foot


Independent Risk Factors for Amputation in Diabetic Foot

Abolfazl Shojaiefard et al. Int J Diabetes Dev Ctries.


Background: Diabetic foot (DF) is the main cause of nontraumatic lower extremity amputation. Early recognition and management of risk factors for foot complications may prevent amputations and other adverse outcomes.

Materials and methods: At our hospital we have a protocol for the management of patients hospitalized because of DF. We collected clinical and laboratory data, details of diabetes complications, and history of comorbidities in 146 patients who were admitted for management of DF to determine the risk factors of amputation (major or minor) in these patients. We divided these patients into two groups, those whose treatment included amputation and those who were treated conservatively and carried out a comparative analysis of the variables in the two groups.

Results: Major amputation was performed in 5.5% of the patients and minor amputation in 22.6%. Those who required amputation presented a significantly higher (P < 0.05) incidence of nephropathy, history of previous amputation, ischemic diabetic foot and first fasting blood glucose (FBG) > 200 mg/dl after admission. Multivariable-adjusted odds ratios in stepwise logistic regression model was 2.64 for nephropathy (95%CI: 1.06 to 6.60; P = 0.03); 3.03 for ischemic diabetic foot (95%CI: 1.28 to 7.18; P = 0.01); and 3.01 for first FBG > 200 after admission (95%CI: 1.32 to 6.83; P= 0.01).

Conclusion: Nephropathy, ischemic diabetic foot, and first FBG > 200 mg/dl are independent predictors of limb amputation in patients hospitalized for DF lesions. In addition to early detection and treatment of foot lesions, early management of risk factors is also important.

Keywords: Amputation; diabetic foot; gangrene.

Conflict of interest statement

Conflict of Interest: None declared.

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    1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes, estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–53. - PubMed
    1. Reiber GE, Lipsky BA, Gibbons GW. The burden of diabetic foot ulcers. Am J Surg. 1998;176:5–10. - PubMed
    1. Calle-Pascual AL, Redondo MJ, Ballesteros M, Martinez-Salinas MA, Diaz JA, De Matias P, et al. Nontraumatic lower extremity amputations in diabetic and non-diabetic subjects in Madrid Spain, Diabetes Metab. 1997;23:519–23. - PubMed
    1. Adler AI, Boyko EJ, Ahroni EH, Smith DG. Lower-extremity amputation in diabetes: The independent effects of peripheral vascular disease, sensory neuropathy and foot ulcers. Diabetes Care. 1999;22:1029–35. - PubMed
    1. Goodridge D, Trepman E, Embil JM. Health-related quality of life in diabetic patients with foot ulcers: Literature review. J Wound Ostomy Cont Nurs. 2005;32:368–77. - PubMed

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