Risk Factors for Amputation Among Patients with Diabetic Foot Disease in a Tertiary Hospital A Retrospective Case-control Study
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Abstract
Background. Amputation is commonly indicated to control infection in patients with diabetic foot disease. There were over 3.7 million diabetic adults in the Philippines in 2017. Around 4 of 1000 patients with diabetes underwent lower extremity amputations.
Objective. This study aimed to evaluate patients with diabetic foot disease who underwent lower extremity amputation at a tertiary hospital and analyze possible risk factors for their amputations.
Methodology. Records of patients treated for diabetic foot disease from 2017 to 2021 were reviewed. We identified risk factors such as sex, renal disease, arterial duplex scan, white blood cell count, HbA1c level, Wagner classification, and history of cigarette smoking, and correlated these with amputation.
Result. In 260 patients, older age, arterial occlusion (i.e., monophasic results on arterial duplex scan), poorer soft tissue status (i.e., higher Wagner classification), and higher WBC levels increased the likelihood of amputation. Renal disease, sex, smoking, and hemoglobin A1c (HbA1c) were not significantly related.
Conclusion. The factors associated with amputation in patients with diabetic foot disease were similar to those in
literature, including age, soft tissue compromise, elevated white blood cell levels, and monophasic arterial duplex
scans. Renal disease, sex, smoking, and HbA1c were not found to be statistically significant factors in this study.
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