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Costa RHR, Cardoso NA, Procópio RJ, Navarro TP, Dardik A, de Loiola Cisneros L, et al.
Diabetes & metabolic syndrome. Date of publication 2017 Dec 1;volume 11 Suppl 2():S583-S587.
1. Diabetes Metab Syndr. 2017 Dec;11 Suppl 2:S583-S587. doi: 10.1016/j.dsx.2017.04.008. Epub 2017 Apr 12. Diabetic foot ulcer carries high amputation and mortality rates, particularly in the presence of advanced age, peripheral artery disease and anemia. Costa RHR(1), Cardoso NA(2), Procópio RJ(3), Navarro TP(4), Dardik A(5), de Loiola Cisneros L(6). Author information: (1)University Hospital, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. (2)Post-Graduate Program for Surgery and Ophthalmology, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. (3)Endovascular Unit of University Hospital, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. (4)Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. (5)Department of Surgery, Yale School of Medicine, New Haven, CT, USA. (6)Department of Physiotherapy, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. Electronic address: ligialoyola@gmail.com. INTRODUCTION: Foot ulcer is also a clinical marker for limb amputation and for death in diabetic patients. The purpose of this study was to determine amputation and mortality rates and its associated factors in patients with diabetic foot ulcerations in a tertiary hospital in Brazil. METHODS: Retrospective medical records from 654 diabetic foot patients were reviewed. The risk factors were determined using the conditional logistic regression model analysis. RESULTS: The mean patient age was 63.1 years (SD 12.20). Peripheral arterial disease was present in 160 patients (24.5%). Major amputations were performed in 135 (21%). The in-hospital mortality rate was 12% and the mortality rate of the amputees was 22.2%. The lowest hemoglobin level, the median value was 9.50g/dL, (4.0-17.0). Anemia was detected in 89.6% of patients submitted to amputation and in 82,1% of those who died. Hemoglobin <11g/dL was the most significant risk factor for major amputation (odds ratio 5.57, p<0.0001). The presence of peripheral arterial disease and old age were also a risk for major amputation (odds ratio 1.84, p=0.007 and 1.02, p=0.028, respectively). Factors associated with increased risk for death were hemoglobin <11g/dL (odds ratio 4.04, p<0.001), major amputation (1.79, p=0.03) and old age (1.05, p<0,001). CONCLUSIONS: Diabetic foot ulcer is associated with high amputation and mortality rates. Old age, peripheral arterial disease and low hemoglobin level are risk factor for major amputation. Old age, major amputation and low hemoglobin level are risk factors for death. Copyright © 2017. Published by Elsevier Ltd. DOI: 10.1016/j.dsx.2017.04.008 PMID: 28465149 [Indexed for MEDLINE]
Appears in following Topics:
Diabetic Foot Ulcer - Introduction and Assessment