scholarly journals Evaluation of risk factors for lower extremity amputation in diabetic foot ulcer: a hospital based observational study in Northern India

2019 ◽  
Vol 7 (4) ◽  
pp. 1190
Author(s):  
Bhavkaran Singh Bal ◽  
Gagan Khanna ◽  
Aditya Bhardwaj ◽  
Kamalpreet Singh
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Lower Extremity ◽  
Foot Ulcer ◽  
Lower Extremity Amputation ◽  
Socioeconomic Background ◽  
Diabetic Patients ◽  
Group A ◽  
Group B ◽  
Extremity Amputation

Background: The present prospective observational study was done to analyse the risk factors leading to minor or major lower extremity amputation (LEA) in diabetic patients.Methods: A 139 patients were divided into Group A (n=113) and Group B (n=26) who underwent minor and major LEA respectively.Results: Majority of the patients in group B were from rural and lower socioeconomic background.  Duration of diabetes (p=0.017) and  of DFU was significantly longer in group B (P <0.001) The pro-portion of patients with Wagner Grade 4 and 5  ulcer were significantly higher in group B than in group A (P <0.001) Wound infection and maggots were significantly higher in group B though polymicrobial infection was higher in group A. Biochemical investigations were abnormally altered but difference between two groups was not significant.Conclusions: Socioeconomic burden on the society due to LEA can be reduced by making diabetic patients aware of foot hygiene, regular medical check-up for control of diabetes and associated complications.

scholarly journals Predictive risk factors for lower limb amputations in patients with diabetic foot ulcer in correlation with Wagner’s grading

2021 ◽  
Vol 8 (12) ◽  
pp. 3576
Author(s):  
Ambikavathy Mohan ◽  
Saideep Ravura ◽  
Kumar Srinivasan
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Extremity Amputation ◽  
Diabetic Patients ◽  
Team Approach ◽  
Multidisciplinary Team Approach ◽  
Extremity Amputation

Background: Lower extremity amputation in diabetic patients results in high morbidity causing poor quality of life despite high medical expenses. A correlate of risk factors with Wagner‘s grading of foot ulcers and their improvement with multidisciplinary team approach would form a basis for preventive diabetic foot care guidelines in health care policy. Objectives of current study were to assess the risk factors and role of multidisciplinary team approach in patients undergoing lower extremity amputations with diabetic footulcer with different Wagner‘s grading.Methods: Prospective data of diabetic patients above eighteen years with foot ulcers admitted in departments of general surgery/general medicine at Vydehi Institute of medical sciences and research centre, between October 2017 to October 2019 were included. Multi-disciplinary treatment approach was adopted and treated accordingly. Patients were followed up for three months to reassess the risk factors for lower extremity amputation and correlated with Wagner‘s grading system and analyzed using descriptive statistical analysis, SPSS-21.Results: fifty patients with Wagner’s grade 1-4 of which forty four (88%) males and six (12%) females. Four (8%) of the patients underwent major limb amputation. 18% underwent minor amputation and 16% SSG. 54% were grade 3,4 on day 1 and 24% patients were grade 3, 4 and 5 after 3 months of follow up (p=0.034).Conclusions: Clinical assessment of diabetic foot ulcer and identification of risk factors for the nonhealing predicts the favourable outcome in the management of diabetic foot combined with multi-disciplinary team approach strategy.

scholarly journals Risk Factors for Lower Extremity Amputation in Diabetic Foot Ulcer Patients: A Case-Control Study

2020 ◽  
Vol 11 (2) ◽  
pp. 83
Author(s):  
Gusti Agung Ayu Ira Kencana Dewi ◽  
Sony Wibisono ◽  
I Putu Alit Pawana
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Diabetic Foot ◽  
Medical Records ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Extremity Amputation ◽  
History Of ◽  
Extremity Amputation ◽  
Control Study

Introduction: Diabetes mellitus is a metabolic syndrome that is marked by higher blood glucose. The uncontrolled high blood glucose can lead to complication, such as diabetic foot. Diabetic foot is the most reason why diabetic patients are hospitalized. Diabetic foot that cannot heal may lead to lower extremity amputation. The purpose of this study was to describe the risk factors of lower extremity amputation in diabetic foot ulcer patients.Methods: This study used a case-control study of diabetic foot patients in Dr. Soetomo General Hospital from January 2015 to December 2017. This study used the data from medical records in Inpatient Installation Department of Internal Medicine. Patients with diabetic foot ulcer and lower extremity amputation due to diabetes were included in this study. Incomplete medical records were excluded. Data of samples were divided to two groups, i.e. the amputation group and the non-amputation group with a ratio of 1:1. Risk factors of amputation that were analyzed were male, old age, and the history of ulcer/lower extremity amputation.Results: Based on the data of 36 samples, there were 11 male patients (61.1%) and 7 female patients (38.9%) who experienced lower extremity amputation. The average age of amputation group was 59.61 years old with a range of ages from 39 to 72 years old. This study found the risk factors for lower extremity amputation in diabetic foot ulcer patients was the history of ulcer/amputation due to diabetes (OR 5.0, 95% CI 1.065-23.464, p = 0.034). Conclusion: The risk factor for lower extremity amputation in diabetic foot ulcer patients was the history of ulcer/amputation due to diabetes. 

scholarly journals Predictors of lower extremity amputation in patients with diabetic foot ulcer

2019 ◽  
Vol 6 (4) ◽  
pp. 1208
Author(s):  
Girish Thimmanalli Umashankar ◽  
Anil Kumar M. S. ◽  
Mohammed Shahid
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Diabetic Foot ◽  
Classification System ◽  
Adverse Outcome ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Extremity Amputation ◽  
Assessment Model ◽  
Extremity Amputation

Background: Diabetic foot lesions are responsible for more hospitalisations than any other complication of diabetes and diabetes is a predominant aetiology for non-traumatic lower extremity amputations. Authors, therefore, examined the clinical characteristics that best predict poor outcome in a large population of diabetic foot ulcer patients. The objective of the study was to describe independent predictors for lower extremity amputation in patients with a diabetic foot ulcer and to validate the predictive value of PEDIS (IWGDF) classification system for a diabetic foot ulcer.Methods: A retrospective study of 197 patients presenting with diabetic foot ulcer presenting to a tertiary care hospital in Mysuru, India. The recorded parameters were age, sex, various risk factors, laboratory parameters, the presence of DM-related complications and ulcer characteristics as determined by PEDIS system. The main outcomes recorded were healed ulcer and amputation.Results: Authors have found that factors strongly associated with risk of amputation are (in order of strength): PVD, past amputation, nephropathy, past ulcer, ulcer duration, TLC, Hb and sr. creatinine. Authors also validated the PEDIS scoring system as an effective classification system with prognostic value. The PEDIS score of >7 is a highly significant predictor of adverse outcome (amputation) of diabetic foot ulcer.Conclusions: Several risk factors for lower extremity amputation in a patient with diabetic foot ulcer were identified. An integrated risk-assessment model including the above significant risk factors and PEDIS system can be developed that is both clinically accurate as well as quick to assess for predicting the adverse outcome in a patient of diabetic foot ulcer and providing an opportunity to save the limb.

Lower-extremity amputation. Incidence, risk factors, and mortality in the Oklahoma Indian Diabetes Study

Diabetes ◽  
1993 ◽  
Vol 42 (6) ◽  
pp. 876-882 ◽  
Author(s):  
J. S. Lee ◽  
M. Lu ◽  
V. S. Lee ◽  
D. Russell ◽  
C. Bahr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Lower Extremity Amputation ◽  
Incidence Risk ◽  
Extremity Amputation

scholarly journals Potentially Preventable Hospitalizations and the Burden of Healthcare-Associated Infections

2017 ◽  
Vol 4 ◽  
pp. 233339281772110 ◽  
Author(s):  
Andrea L. Lorden ◽  
Luohua Jiang ◽  
Tiffany A. Radcliff ◽  
Kathleen A. Kelly ◽  
Robert L. Ohsfeldt
Keyword(s):  
Clostridium Difficile ◽  
Lower Extremity ◽  
Clostridium Difficile Infection ◽  
Lower Extremity Amputation ◽  
Diabetic Patients ◽  
Healthcare Associated Infections ◽  
Preventable Hospitalizations ◽  
Potentially Preventable Hospitalizations ◽  
Healthcare Associated ◽  
Extremity Amputation

Background: An estimated 4% of hospital admissions acquired healthcare-associated infections (HAIs) and accounted for $9.8 (USD) billion in direct cost during 2011. In 2010, nearly 140 000 of the 3.5 million potentially preventable hospitalizations (PPHs) may have acquired an HAI. There is a knowledge gap regarding the co-occurrence of these events. Aims: To estimate the period occurrences and likelihood of acquiring an HAI for the PPH population. Methods: Retrospective, cross-sectional study using logistic regression analysis of 2011 Texas Inpatient Discharge Public Use Data File including 2.6 million admissions from 576 acute care hospitals. Agency for Healthcare Research and Quality Prevention Quality Indicator software identified PPH, and existing administrative data identification methodologies were refined for Clostridium difficile infection, central line–associated bloodstream infection, catheter-associated urinary tract infection, and ventilator-associated pneumonia. Odds of acquiring HAIs when admitted with PPH were adjusted for demographic, health status, hospital, and community characteristics. Findings: We identified 272 923 PPH, 14 219 HAI, and 986 admissions with PPH and HAI. Odds of acquiring an HAI for diabetic patients admitted for lower extremity amputation demonstrated significantly increased odds ratio of 2.9 (95% confidence interval: 2.16-3.91) for Clostridium difficile infection. Other PPH patients had lower odds of acquiring HAI compared to non-PPH patients, and results were frequently significant. Conclusions: Clinical implications include increased risk of HAI among diabetic patients admitted for lower extremity amputation. Methodological implications include identification of rare events for inpatient subpopulations and the need for improved codification of HAIs to improve cost and policy analyses regarding allocation of resources toward clinical improvements.

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