An evaluation of risk factors affecting amputation in patients with diabetic foot Infection

Authors : Handan ALAY, Sinan YILMAZ, Fatma KESMEZ CAN, Mehmet PARLAK

Pages : 49-54

Doi:10.32322/jhsm.809986

View : 18 | Download : 8

Publication Date : 2021-01-21

Article Type : Research Paper

Abstract :Introduction: Diabetic foot infections are one of the most common complications of diabetes and generally result in lower extremity amputations. Aim: The purpose of this study is to investigate risk factors affecting amputation in patients diagnosed with diabetic foot ulcer. Materials and Methods: This prospective cohort study involved 137 patients diagnosed with diabetic foot infection in a university hospital diabetic foot clinic. Results: The mean age of the participants was 60.5±10.1 years, and 70.8% insert ignore into journalissuearticles values(n=97); were men. The majority of patients insert ignore into journalissuearticles values(62.0%); were educated to elementary or middle school level, while 26.3% were illiterate. Mean duration of diabetes was 13.3±6.2 years. Hypertension was present in 48.2% of patients, hypercholesterolemia in 31.4%, cardiovascular disease insert ignore into journalissuearticles values(CVD); in 38%, peripheral artery disease insert ignore into journalissuearticles values(PAD); in 21.2%, peripheral venous insufficiency in 10.2%, and polyneuropathy in 70.1%, and 9.5% were receiving hemodialysis. According to the Infectious Diseases Society of America classification, moderate foot ulcers were present in 60.6% of patients, mild ulcers in 34.3%, and severe ulcers in 5.1%. Forty-six percent of patients were diagnosed with osteomyelitis during follow-up. Amputation was present in 28.5% insert ignore into journalissuearticles values(n=39); of the patients followed-up due to foot ulcers. PAD increased the risk of amputation 2.7-fold insert ignore into journalissuearticles values(95% CI: 1.02-7.14);, osteomyelitis 2.6-fold insert ignore into journalissuearticles values(95% CI: 1.10-6.16);, and repeated hospitalizations 5.9-fold insert ignore into journalissuearticles values(95% CI: 2.25-15.33);. Growth was observed in 72.6% of patients without amputation, 76.5% were polymicrobial, and 65.9% of antibiogram results were multidrug resistant. No significant difference was observed among the patients in terms of multidrug resistance insert ignore into journalissuearticles values(p=0.468);. Conclusion: PAD, osteomyelitis, and history of repeated hospitalizations are separate risk factors for amputation in patients with diabetic foot ulcers.
Keywords : Diabetic foot, amputation, risk factors, infection, multidrug resistance