Prevalence and risk factors for Diabetic foot lower limb amputation: A hospital based case control study

Dr Anurag Khare; Dr Vijai Kumar Misra

Volume : VI, Issue : XI, November - 2017

Prevalence and risk factors for Diabetic foot lower limb amputation: A hospital based case control study

Dr Anurag Khare, Dr Vijai Kumar Misra

Abstract :

Background: Diabetic Foot Ulcer occurs as a diabetic complication and involves a multi factorial pathogenesis including peripheral neuropathy as the primary causal factor, together with variable contribution from peripheral vascular disease (PVD), repetitive trauma, and superimposing foot infection. Infected DFU is a major cause of prolonged hospital admission and contributes over 90% of non traumatic lower limb amputations (LLAs), which is more than a million amputations/year. Objectives: The aim of the study was to evaluate the prevalence of and risk factors for lower limb amputation in a specialist foot hospital–based setting. Material and Methods: A retrospective quantitative study was conducted, using clinical and biochemical profiles of diabetic foot patients attending the High Risk Foot Clinic at Career Institute of Medical Sciences and Hospital, between January 1, 2016, and December 31, 2016. Results: The total study sample included 110 subjects, comprising 80 males and 30 females with M: F ratio of 2.6 : 1. The average age of the cohort was 63.4 years � 14.1 years [CI 90.98–65.89]. Lower limb amputation was identified as a common and significant outcome (𝑛 = 40), occurring in 35%, more commonly amongst the indigenous population (56.5% versus 29.2%; 𝑝 = 0.94, OR 0.94). Risk factors most closely associated with amputation included diabetic retinopathy (𝑝 = 0.00, OR 4.4), coronary artery bypass graft (CABG) surgery (𝑝 = 0.01, OR 4.1), Charcot�s arthropathy (𝑝 = 0.01, OR 2.9), and Indigenous ethnicity (𝑝 = 0.01, OR 3.4). Conclusion: Lower limb amputation is a common outcome and linked to ethnicity and neurovascular diabetic complications amongst subjects with diabetic foot ulcer. Further research is needed to identify why risk of lower limb amputation seems to differ according to ethnicity.