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- Title
Factors Associated With Lower-Extremity Amputation in Patients With Diabetic Foot Ulcers.
- Authors
Kanzer, Daniel; Rao, Amit; Kaplan, Sally; Caprioli, Russell; Haight, John G.; Pliskin, Michael; Oropallo, Alisha
- Abstract
Objective: To explore factors associated with lower-extremity amputation (LEA) in patients with diabetic foot ulcers using data from the Online Wound Electronic Medical Record Database. Design: Retrospective analysis of medical records. Setting and participants: Data from 169 individuals with previously diagnosed diabetes mellitus who received wound care for a 6-month period within a span of 2 years was analyzed. A baseline evaluation was obtained and wound(s) were treated, managed, and monitored. Treatment continued until the patient healed, required an LEA, or phased out of the study, neither healing nor undergoing an amputation. Of the 149 patients who completed the study, 38 had healed ulcers, 14 underwent amputation, and 97 neither healed nor underwent an amputation. All patients were treated under the care of vascular and/or podiatric surgeons. Measurements: Variables included wound status (healed, amputated, and unhealed/non-amputated); size of wound area; age, gender, race, and ethnicity; white blood cell WBC) count, hemoglobin A1c (HbA1c), blood glucose, and body mass index (BMI); and presence of osteomyelitis, gangrene, and peripheral vascular disease. Results: As compared to the healed and unhealed/nonamputated group, the group of patients who underwent LEA was older and had higher percentages of males, Hispanics, and African Americans; had a higher WBC count, larger wound area, and higher rates of wound infection, osteomyelitis, and neuropathy; and had lower average values of HbA1c, blood glucose, and BMI and a lower rate of peripheral vascular disease. ConclusionPhe association between HbA1c and LEA highlights a window of relative safety among an at-risk population. By identifying and focusing on factors associated with LEA, health care professionals may be able to decrease the prevalence of LEA in patients with diabetes.
- Subjects
AMPUTATION; CONFIDENCE intervals; DATABASES; FOOT ulcers; GANGRENE; GLYCOSYLATED hemoglobin; MEDICAL information storage &; retrieval systems; LEG; LEUCOCYTES; MEDICAL records; TYPE 2 diabetes; OSTEOMYELITIS; PERIPHERAL vascular diseases; RISK assessment; WOUND healing; TRAUMATOLOGY diagnosis; LOGISTIC regression analysis; DIABETIC foot; BODY mass index; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; ACQUISITION of data methodology; ODDS ratio
- Publication
Journal of Clinical Outcomes Management, 2020, Vol 27, Issue 2, p73
- ISSN
1079-6533
- Publication type
Article