Clinical characteristics and risk factors of lower extremity amputation in patients with diabetic foot

  • Linru Wang
  • Qiang Li Qingdao Hiser Medical Group
  • Xiao Chen
  • Zhaowei Wang
Keywords: Risk factors, Lower extremity amputation, Diabetic foot

Abstract

Objectives: To investigate the risk factors of lower limb amputation, and help physicians better understand the clinical characteristics of patients with diabetic foot, and make treatment strategies for these patients correctly.

Methods: In this study, the inpatients with diabetic foot treated in our hospital form January 2013 to February 2021 were reviewed retrospectively. The patients were divided into amputation and conservative treatment groups. The variables of the patients, consisting of age, gender, smoking history, alcohol use, diabetes and ulcer duration, ulcer size, Wagner classification, ankle brachial index, previous amputation history, laboratory data, and medical comorbidities including hypertension, coronary artery disease, peripheral arterial disease, chronic renal insufficiency, retinopathy, and sequelae of cerebral infarction were selected for analysis to determine the risk factors of lower limb amputation.

Results: In this study, a total of 856 patients with diabetic foot were enrolled, in which 487 patients received amputation surgeries, and the amputation rate was 56.9%. There were significant differences between the two groups in gender (p=0.014), smoking history (p=0.011), ulcer duration (p=0.023), ulcer size (p=0.000), Wagner classification (p=0.000), ABI (p=0.031), peripheral arterial disease (p=0.000), HDL-C (p=0.013), osteomyelitis (p=0.000), and fibrinogen (p=0.001). A stepwise multiple logistic regression analysis revealed that male gender (p=0.003), larger ulcer size (p=0.001), higher Wagner classification grades (p=0.002), higher rate of peripheral arterial disease (p=0.02) and osteomyelitis (p=0.0001), and increased fibrinogen level (p=0.004) were independent risk factors of lower limb amputation in patients with diabetic foot.

Conclusion: The diabetic foot patients with male sex, larger ulcer size, higher grade of Wagner classification, peripheral arterial disease or higher fibrinogen level may face higher risk of lower limb amputation.

doi: https://doi.org/10.12669/pjms.38.8.5635

How to cite this:
Wang L, Li Q, Chen X, Wang Z. Clinical characteristics and risk factors of lower extremity amputation in patients with diabetic foot. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.5635

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2022-09-16
How to Cite
Wang, L., Li, Q., Chen, X., & Wang, Z. (2022). Clinical characteristics and risk factors of lower extremity amputation in patients with diabetic foot. Pakistan Journal of Medical Sciences, 38(8). https://doi.org/10.12669/pjms.38.8.5635
Section
Original Articles