scholarly journals Risk factors of amputation in diabetic foot infections

2018 ◽  
Vol 5 (4) ◽  
pp. 1399 ◽  
Author(s):  
Quraysh Shabbir Sadriwala ◽  
Bapuji S. Gedam ◽  
Murtaza A. Akhtar
Keyword(s):  
Risk Factors ◽  
Peripheral Neuropathy ◽  
Glycemic Control ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Factors Associated ◽  
Diabetic Foot Infections

Background: Diabetes is the most common underlying cause of foot ulcers, infection, and ischemia, leading to hospitalization and the most frequent cause of non-traumatic lower extremity amputation. Despite well-defined risk factors for diabetic foot ulcer development, limited data are available as to which factors predict amputation in a diabetic foot ulcer episode. Therefore, to predict lower limb amputation occurrence and to determine the factors associated with the risk of amputation in diabetic patients, we conducted this study.Methods: A hospital based longitudinal study was carried out to assess the risk factors associated with amputation in diabetic foot infection. Patients with foot infections, who were either a diagnosed case of diabetes mellitus or were diagnosed at the institute were included in the study. We excluded patients receiving immunosuppressive therapy or radiotherapy, and infections at or above the ankle joint. Study factors were demographic details, biochemical parameters, Wagner grading, peripheral neuropathy as evaluated by nerve conduction test and vasculopathy as assessed by Ankle brachial index. The primary outcome factor was amputation. The data was presented as descriptive statistics and analyzed by dividing the patients into amputation and non-amputation group, and univariate and multivariate analysis was done.Results: A total of 64 patients were included in the study, out of which the amputation rate was 39.1%. Poor glycemic control, osteomyelitis, vasculopathy, peripheral neuropathy and Wagner grading were statistically significant.Conclusions: In the present study, poor glycemic control, vasculopathy, peripheral neuropathy and higher Wagner grade are significant risk factors for amputation in diabetic foot infections.

scholarly journals Clinical Profile of Patients with Diabetic Foot Ulcer Treated Conservatively or Surgically and Effect of Risk Factors on Ulcer Healing

2021 ◽  
Vol 8 (6) ◽  
pp. 238-244
Author(s):  
Ved Prakash
Keyword(s):  
Risk Factors ◽  
Peripheral Neuropathy ◽  
Glycemic Control ◽  
Ulcer Healing ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Clinical Profile ◽  
Diabetic Patients ◽  
Duration Of Diabetes

Objective: The aim of this study was to assess the clinical profile of patients with diabetic foot ulcer treated conservatively or surgically and effect of risk factors on ulcer healing. Methods: This was a retrospective observational study conducted in tertiary medical teaching hospital where medical records of diabetic patients who were admitted with foot problem were evaluated. All diabetic patients who were aged >18 years and admitted with DFU were included in this study. A structured proforma was used to collect data from the medical record. SPSS version 20.0 was used to perform the statistical analysis. Result: 280 subjects with diabetic foot ulcer (DFU) were evaluated in this study. 71% ulcers were healed where as 11% were persisted unhealed. Patients who were undergone for amputation 12% were minor (Foot only) and 4% were major (above the ankle). A statistically significant association between age, duration of diabetes, glycemic control peripheral neuropathy, and ulcer size were found with diabetic foot ulcer healing. Conclusion: Modifiable factors like good glycemic control, early management of ulcers and early treatment of peripheral neuropathy can influence Diabetic foot ulcer outcomes. Special care should be provided to diabetic subjects who are aged and have longer duration of diabetes. Keywords: Diabetic foot ulcers, ulcer severity, clinical profile, Wagner’s Classification, outcome.

scholarly journals Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Tesfamichael G. Mariam ◽  
Abebaw Alemayehu ◽  
Eleni Tesfaye ◽  
Worku Mequannt ◽  
Kiber Temesgen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Care Practice ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.

scholarly journals DIABETIC FOOT INFECTIONS;

2008 ◽  
Vol 15 (01) ◽  
pp. 153-161
Author(s):  
MUHAMMAD SAEED AKHTAR ◽  
MAQSOOD AHMAD ◽  
MUHAMMAD BADAR BASHIR ◽  
Muhammad Irfan ◽  
Zahid Yasin Hashmie
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Surgical Department ◽  
Diabetic Foot Infections ◽  
Group A ◽  
Hospital Stays ◽  
Male Patients ◽  
Group B

Objective: (1) To evaluate the effects of G-CSF in eliminating infection in diabetic foot wound (2) Tocompare the effects with conventional diabetic foot management. Design: Prospective, open, randomized comparativestudy. Setting: Medical&Surgical Department of Allied, DHQ Hospital & Nawaz Medicare Faisalabad. Period: FromJan 2000 to Nov 2000 Patients & Methods: Fifty diabetic patients with foot infections were included in this study. Themean age was 52 years ranging from 27 to 60 years. They were divided into two equal groups(Group A and Group B).Results: The male patients were 41(82%) and female 9(18%). Forty six percent of patients were on oral hypoglycaemicdrugs, and 54% on insulin. The trauma preceding infection was 20%, Peripheral neuropathy 94% and peripheralvascular disease 34%. Thirty two percent of patients were smoker. Group A were subjected to G-CSF ( Neupogen )therapy (n=25) subcutanously daily for 5days in addition to conventional measures. Whereas patients in Group Breceived only conventional therapy. Both groups received similar antibiotic and insulin treatment. G-CSF therapy wasassociated with earlier eradication of pathogens from the infected ulcer (median 5 [range 2-11] vs11 [6-31] days in thegroup B; (p=<O.000I), quicker resolution of cellulitis (6 vs l4 days; p<O.0001), shorter hospital stay (8 vsl6 days;p<O.000l), and a shorter duration of intravenous antibiotic treatment (7 vs l4 days ;p—0.0001).No G-CSF treatedpatient needed surgery, whereas three patients in group B underwent toe amputation and six had extensivedebridement under anaesthesia (p=0.00 1). G-CSF therapy was generally well tolerated. Conclusion: Granulocytecolony stimulating factor (G-CSF) may be used as a good adjuvant therapy along with conventional measures for themanagement of diabetic foot infection, as it promotes the healing of diabetic foot ulcer/cellulitis and consequentlyprevents many hazardous complications like amputation of limbs, long hospital stays, extensive and prolonged antibioticuse and last but not the least the total misery of the patients.

Risk factors associated with diabetic foot ulcer-free survival in patients with diabetes

2018 ◽  
Vol 12 (6) ◽  
pp. 1039-1043 ◽  
Author(s):  
Leila Yazdanpanah ◽  
Hajieh Shahbazian ◽  
Iraj Nazari ◽  
Saeed Hesam ◽  
Fatemeh Ahmadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Free Survival ◽  
Factors Associated ◽  
Patients With Diabetes

scholarly journals Prevalence of diabetic complications and risk factors among diabetic foot ulcer patients: a retrospective hospital-based study

2018 ◽  
Vol 5 (11) ◽  
pp. 3608
Author(s):  
Shanmuga Raju P. ◽  
Venkata Ramana N. ◽  
Surya Narayana Reddy V. ◽  
Bhagya Seela S. ◽  
Sachin G.
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Blood Sugar ◽  
Diabetic Foot ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Care Hospital ◽  
The Mean

Background: Diabetic foot ulcer is a painful, demands increased health care utilization, and increases healthcare costs for the patients as well as the health care system. The purpose of this study was to analysis the prevalence of diabetic foot complications and risk factors among diabetic patients at tertiary care Hospital, Karimnagar.Methods: Total 60 sample sizes were included in the study. The study was conducted at General Surgery ward, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar from July 2017 to June 2018. Demographic, complications and risk factors were recorded, and outcomes were analyzed using SPSS statistics version 21.0.Results: The Mean age of the study group is 50.31±14.26 years. The male to female distribution is 47 (78.3%) and 13 (21.7%) respectively. The mean duration of illness in days is 96.68±289.21, while mean HbA1C is 9.44±9.02. The mean fasting blood sugar and postprandial blood sugar is 159.78±70.01 and 157.78±86.28 which shown no significance difference (p = 0.87). Odds ratio with 95% confidence interval was computed to the level of significant.Conclusions: There was no significant outcome was found in diabetic foot ulcer. Patient with high risk complications need as early detection, foot care education, moderate physical, exercise, fitted foot wear and diabetic diet should be decrease the risk of diabetic foot ulcers.

scholarly journals Diabetic foot ulcers: Retrospective comparative analysis from Sicily between two eras

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0259405
Author(s):  
Valentina Guarnotta ◽  
Stefano Radellini ◽  
Enrica Vigneri ◽  
Achille Cernigliaro ◽  
Felicia Pantò ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Cox Regression ◽  
Age Of Onset ◽  
Age At Onset ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Risk Of Death

Aim The aim of this study was to analyze changes in the incidence, management and mortality of DFU in Sicilian Type 2 diabetic patients hospitalized between two eras, i.e. 2008–2013 and 2014–2019. Methods We compared the two eras, era1: 2008–13, era2: 2014–19. In era 1, n = 149, and in era 2, n = 181 patients were retrospectively enrolled. Results In the population hospitalized for DFU in 2008–2013, 59.1% of males and 40.9% of females died, whilst in 2014–2019 65.9% of males and 34.1% of females died. Moderate chronic kidney disease (CKD) was significantly higher in patients that had died than in ones that were alive (33% vs. 43%, p < 0.001), just as CKD was severe (14.5% vs. 4%, p < 0.001). Considering all together the risk factors associated with mortality, at Cox regression multivariate analysis only moderate-severe CKD (OR 1.61, 95% CI 1.07–2.42, p 0.021), age of onset greater than 69 years (OR 2.01, 95% CI 1.37–2.95, p <0.001) and eGFR less than 92 ml/min (OR 2.84, 95% CI 1.51–5.34, p 0.001) were independently associated with risk of death. Conclusions Patients with DFU have high mortality and reduced life expectancy. Age at onset of diabetic foot ulcer, eGFR values and CKD are the principal risk factors for mortality.

scholarly journals Diabetes a risk for antimicrobial resistance?

2017 ◽  
Vol 6 (12) ◽  
pp. 2811 ◽  
Author(s):  
Vasavi Gedela ◽  
Sree Lakshmi Gosala
Keyword(s):  
Antimicrobial Resistance ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Resistance Pattern ◽  
Causative Organism ◽  
Diabetic Patients ◽  
Diabetic Foot Infections ◽  
Significant Difference ◽  
Resistance Rates

Background: Diabetic foot infections can cause substantial morbidity. The role of Diabetes mellitus in the antimicrobial resistance of pathogens in patients with foot infections is not well clarified. So, we compared the profile of antibiotic resistance in diabetic and non-diabetic foot ulcer infections. Objectives were to compare the antimicrobial resistance pattern in diabetic and non-diabetic lower limb infections.Methods: T Pus was isolated in 50 Diabetic and 50 non-diabetic foot ulcer infections. The organisms were isolated on specific media and antibiotic susceptibility was done by using Kirby-Bauer disc diffusion method.Results: The most frequent causative organism in diabetic and non-diabetics is Pseudomonas 27.5% vs 27.1%, Staphylococcus 24.1% vs 27.1%, Klebsiella 24.1% vs 22.03%, E. coli 10.3% vs 10.16%, Proteus 5.17% vs 5.08%. No significant differences in resistance rates to Amikacin, Penicillin, Ofloxacin, Vancomycin, Piperacillin + Tazobactum were observed between diabetic and non-diabetic patients. There is significant difference in resistance to Ampicillin (p=0.017).Conclusions: Diabetes per se does not seem to influence the susceptibility pattern to antimicrobials in our group of patients with foot ulcer infections.

scholarly journals Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients on Follow-Up Clinic at Jimma Medical Center, Southwest Ethiopia, 2019: An Institutional-Based Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Daba Abdissa ◽  
Tesfaye Adugna ◽  
Urge Gerema ◽  
Diriba Dereje
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Foot ◽  
Medical Center ◽  
Previous History ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
History Of

Background. Diabetic foot ulceration is a devastating complication of diabetes mellitus and is a major source of morbidity and mortality. So far, there are few published data on diabetic foot ulcers and its determinants among diabetic patients on follow-up at Jimma Medical Center. Hence, the aim of this study was to assess the prevalence of diabetic foot ulcer and its determinants among patients with diabetes mellitus at Jimma Medical Center. Methods. A hospital-based cross-sectional study was conducted from June 1 to August 30, 2019, and systematic random sampling technique was applied. The total number of study subjects who participated in the study was 277. Data were collected using an interview-administered structured questionnaire. Data were entered into EpiData version 3.1 and exported to SPSS version 20 software for analysis. Analysis was done using descriptive statistics and logistic regression. A variable having a p value of <0.25 in the bivariate model was subjected to multivariate analysis to avoid confounding the variable’s effect. Adjusted odds ratios (AOR) were calculated at 95% confidence interval and considered significant with a p value of ≤0.05. Result. The mean of age of participants was 50.1±14.19 years. More than three-fourths of participants (82.7%) were type 2 DM. The mean duration of diabetic patients was 6.00±5.07 years. The prevalence of diabetic foot ulcer was 11.6% among study participants. According to multivariate logistic regression analysis, previous history of ulceration (AOR=5.77; 95% CI: 2.37, 14.0) and peripheral neuropathy (AOR=11.2; 95% CI: 2.8, 44.4) were independent predictors of diabetic foot ulcer. Conclusion. The prevalence of diabetic foot ulcer was 11.6%. Previous history of ulceration and peripheral neuropathy were associated with diabetic foot ulcer. The health care providers are recommended to thoroughly give emphasis during follow-up of patients who had previous history of ulceration and peripheral neuropathy in order to decrease the occurrence of diabetic foot ulcer.

The Neuro-Vascular Consequence of Diabetes: Foot Amputation and Evaluation of its Risk Factors and Health-Related Economic Impact

2020 ◽  
Vol 19 (1) ◽  
pp. 102-109
Author(s):  
Iftikhar Haider Naqvi ◽  
Abu Talib ◽  
Sajjad Haider Naqvi ◽  
Lubabah Yasin ◽  
Nayema Zehra Rizvi
Keyword(s):  
Risk Factors ◽  
Peripheral Neuropathy ◽  
Peripheral Artery Disease ◽  
Diabetic Foot ◽  
Financial Burden ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Peripheral Artery ◽  
Health Related ◽  
Artery Disease

Background: The rising prevalence of type 2 diabetes mellitus (T2DM) with the huge burden of diabetic foot amputation is a challenge to the health economy of Pakistan and other countries. Identification of various risk factors for amputation, along with its financial burden, is needed to address this problem. Objectives: This study aimed to determine the financial burden and risk factors associated with T2DMrelated foot amputation. Methods: Retrospective hospital-based study from January 2017 to December 2018. Patients with T2DM with and without amputation were enrolled. The direct medical costs of amputation along with various risk factors, were determined. Risk factors were evaluated by logistic regression analysis. Results: A total of 1460 patients with T2DM were included; 484 (33%) patients had an amputation. The mean total cost of below knee, fingers and toe amputation was 886.63±23.91, 263.35 ±19.58 and 166.68 ± 8.47 US$, respectively. This difference among groups was significant (p<0.0001). Male gender (odds ratio, OR: 1.29, 1.01-1.63, p=0.037), peripheral artery disease (OR: 1.93, 1.52-2.46, p=0.000), peripheral neuropathy (OR: 1.31, 1.40-1.63, p=0.000), prior diabetic foot ulcer (OR: 2.02, 1.56- 2.56, p=0.000) and raised glycated haemoglobin (HbA1c) (OR: 3.50, 2.75-4.4, p=0.000) were risk factors for amputation. Conclusion: The health-related financial impact of amputations is high. Peripheral artery disease, peripheral neuropathy, prior diabetic foot ulcer and raised HbA1c were risk factors for amputation.

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