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- Title
Assessment of the risk factors determining the prognosis of major and minor limb amputations in patients with diabetic foot ulcers.
- Authors
Okur, Kürşat Tuğrul; Ozan, Fırat; Kahraman, Murat; Melez, Muhammed; Ünlü, Ömer Can; Altun, İbrahim
- Abstract
Background. Diabetes mellitus (DM) is a major global health problem, and its incidence is growing. Depending on this increase, the number of diabetes-related complications will also rise. Objectives. This study aimed to determine the risk factors associated with major and minor amputations resulting from diabetes. Materials and methods. Patients diagnosed with diabetic foot complications (n = 371) and hospitalized between January 2019 and March 2020 were retrospectively evaluated using information obtained from the database of Diabetic Foot Wound Clinic. Examination of the data identified 165 patients for inclusion in the study, who were stratified into major amputation (group 1, n = 32), minor amputation (group 2, n = 66) and non-amputation (group 3, n = 67) groups. Results. Of the 32 patients who underwent major amputations, 84% had a below-knee amputation, 13% had an above-knee amputation and 3% had knee disarticulation. At the same time, 73% of 66 patients who underwent minor amputation had a single-finger amputation, 17% had a multiple-finger amputation, 8% had a transmetatarsal amputation, and 2% had Lisfranc amputation. Laboratory results showed high acute phase protein and low albumin (ALB) levels in patients from group 1 (p < 0.05). Although Staphylococcus aureus was found to be the most common infectious agent, Gram-negative pathogens were dominant (p < 0.05). Also, there was a significant cost difference between the groups (p < 0.05). Furthermore, those aged over 65 had a high Wagner score, high Charlson Comorbidity Index (CCI), long diabetic foot ulcer (DFU) duration, and high white blood cell (WBC) count, all of which were risk factors for major amputation (p < 0.05). Conclusions. This study demonstrated an increased Wagner staging and incidence of peripheral neuropathy (PN) and peripheral arterial disease (PAD) in major amputation patients. In addition, the rate of distal vessel involvement was high in major amputation patients, with elevated acute phase proteins and low ALB levels crucial in laboratory findings.
- Subjects
DIABETIC foot; FOOT diseases; TRAUMATIC amputation; LEG amputation; AMPUTATION; ACUTE phase proteins; PEOPLE with diabetes
- Publication
Advances in Clinical & Experimental Medicine, 2024, Vol 33, Issue 1, p21
- ISSN
1899-5276
- Publication type
Article
- DOI
10.17219/acem/163240