Prevalence and Factors Associated with Lower Limb Amputation in Patients Hospitalized for Diabetic Foot: a Cross-sectional Study

2020 ◽  
Vol 16 ◽  
Author(s):  
Abdourahmane Ndong ◽  
Jacques Noel Tendeng ◽  
Mohamed Lamine Diao ◽  
Diatou Gueye Dia ◽  
Amadou Diop Dia ◽  
...  
Keyword(s):  
Lower Limb ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Male Gender ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Stage D

Background: Diabetes is the leading cause of non-traumatic amputation of the lower limb. Several factors associated with amputation are described in the literature, but they remain not well studied in our context. Objectives: Our aim is to determine the prevalence and factors associated with amputation in patients hospitalized for diabetic foot. Methods: This is a prospective cross-sectional study performed over the period from December 1, 2017 to June 30, 2018. The patients included were those hospitalized for trophic disorders of the foot in patients with type 2 diabetes. The studied parameters were: epidemiological, diagnostic, therapeutic and evolutionary data. An univariate analysis and then a binary logistic regression identified the factors associated with lower limb amputation. Results: We included 53 patients. A lower limb amputation was performed in 8 patients (prevalence of 15.1%). Univariate analysis found as factors associated with major amputation: advanced age (p = 0.031); male gender (p = 0.003); use of traditional treatment (p = 0.036); non-compliance with the diabetic diet (p = 0.016); stage D of the University of Texas (UT) Classification (p = 0.029); grade ≥ 2 of the UT Classification (p = 0.002). Logistic regression finds only the following two variables as independent factor associated with amputation: male gender (p = 0.004, OR = 36.1 and CI = 3.2-402.9); stage D of the UT classification (p = 0.014, OR = 21.3 and CI = 1.8-244.2). Conclusion: Controlling these factors would allow better management of diabetes to avoid complications.

scholarly journals Long-term symptoms and function after war-related lower limb amputation: A national cross-sectional study

2018 ◽  
Vol 52 (5) ◽  
pp. 348-351 ◽  
Author(s):  
Elham Esfandiari ◽  
Amir Yavari ◽  
Amir Karimi ◽  
Mehdi Masoumi ◽  
Mohammadreza Soroush ◽  
...  
Keyword(s):  
Lower Limb ◽  
Cross Sectional Study ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Sectional Study ◽  
Cross Sectional ◽  
And Function

Prostheses Use and Satisfaction among People with Lower-limb Amputation in 10 districts of Bhutan

2019 ◽  
Vol 5 (2) ◽  
pp. 21-27
Author(s):  
Ugyen Norbu ◽  
Tandin Zangpo ◽  
Jit Bahadur Darnal ◽  
Hari Prasad Pokhrel ◽  
Roma Karki
Keyword(s):  
Service Delivery ◽  
Lower Limb ◽  
Cross Sectional Study ◽  
Functional Mobility ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Cross Sectional ◽  
Face To Face ◽  
Level Of Satisfaction ◽  
Lower Limb Prostheses

Introduction: The use of lower-limb prostheses restores functional mobility and improves quality of life for people with lower limb amputation. However, the use of prostheses is significantly impacted by users’ satisfaction with their prostheses and service delivery. Therefore, the excellence of prosthetic rehabilitation is not only assessed by the number of prostheses users but is also determined by the level of satisfaction with the prostheses and services received. The study was conducted to determine prostheses use and satisfaction among people with lower-limb amputation. Methods: A cross-sectional study was conducted among lower-limb prosthetic users in 10 districts of Bhutan. Data was collected by face-to-face interview using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) questionnaire. Participants were recruited by purposive sampling. Results: The study found that 96.4% of persons with lower-limb amputation currently used prostheses and 79% of them have used it for more than 7 hours/day. However, 44% of prostheses needed repair. The total QUEST score of satisfaction was 4.0 (SD 0.5). Conclusion: Majority of lower-limb prostheses are in use and the users reported being quite satisfied with their prostheses and service delivery. The study recommends initiating follow-up services to improve prosthetic use and overall satisfaction scores for both prostheses and service delivery.

scholarly journals Disability, economic and work-role status of individuals and their families in Bangladesh, post-unilateral lower-limb amputation (LLA) and pre-rehabilitation: a cross-sectional study

2021 ◽  
Author(s):  
Md Shapin Ibne Sayeed ◽  
Jodi Oakman ◽  
Michael P. Dillon ◽  
Rwth Stuckey
Keyword(s):  
Lower Limb ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Lower Limb Amputation ◽  
World Health ◽  
Limb Amputation ◽  
Mobility Impairment ◽  
Cross Sectional ◽  
Gendered Roles ◽  
The Impact

Abstract Background To quantify disability, occupation and socioeconomic status of individuals and their families in Bangladesh, post-unilateral lower-limb amputation (LLA) and pre-rehabilitation. Methods Between November 2017 and February 2018, people with unilateral LLA attending two XXX prosthetic rehabilitation centres were surveyed prior to rehabilitation, using the World Health Organization Disability Assessment Schedule (WHODAS-2.0) with additional socio-economic questions. Data was analysed descriptively, and cross-tabulation conducted with Chi-square test and Fisher’s exact tests. Results Seventy-six individuals participated. The majority had transtibial amputation (61.8%) from trauma (64.5%), were young adults (37.92 ± 12.35 years), in paid work prior to LLA (80%), married (63.2%), male (81.6%), from rural areas (78.9%), with primary/no education (72.4%). After LLA, mobility (WHODAS score 74.61 ± 13.19) was the most negatively affected domain. Most (60.5%) participants did not return to a paid or unpaid occupation. Acute healthcare costs negatively impacted most families (89.5%), and over 80% became impoverished. Nearly 70% of previous income-earners became economically dependent resulting in changes to traditional family roles. Conclusions Following LLA, most participants experienced significant mobility impairment, were unable to return to paid occupation and became economically dependent. The study population presents with many different characteristics from other people with LLA globally, which suggest with timely rehabilitation a return to paid employment is possible. The impact of LLA extends beyond the individual, including to families, many of whom face challenges with changes to traditional primary earner gendered roles. Improved access to timely and affordable rehabilitation is required to reduce the significant personal and societal costs of disability after LLA.

scholarly journals HBV and HCV serological markers in patients with the hepatosplenic form of mansonic schistosomiasis

2011 ◽  
Vol 48 (2) ◽  
pp. 124-130 ◽  
Author(s):  
Jéfferson Luis de Almeida Silva ◽  
Veridiana Sales Barbosa de Souza ◽  
Tatiana Aguiar Santos Vilella ◽  
Ana Lúcia C. Domingues ◽  
Maria Rosângela Cunha Duarte Coêlho
Keyword(s):  
Risk Factors ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Northeastern Brazil ◽  
Serological Markers ◽  
Sectional Study ◽  
Serum Samples ◽  
Cross Sectional ◽  
Factors Associated

CONTEXT: Blood transfusion is one of the major risk factors for the transmission of the hepatitis B (HBV) and C (HCV) viruses. However, there are no reports describing the endoscopic transmission of these viruses in patients with the hepatosplenic form of schistosomiasis. OBJECTIVE: To estimate the prevalence of serological markers of HBV and HCV in patients with the hepatosplenic form of schistosomiasis and evaluate the possible risk factors associated with these infections. METHODS: A cross-sectional study was conducted on 230 patients with hepatosplenic form of schistosomiasis who attended a university hospital in Recife, Northeastern Brazil, from February to August 2008. The patients answered a standardized questionnaire about risk factors. Serum samples were analyzed for anti-HBc total, anti-HBs, HBsAg, and anti-HCV using enzyme-linked immunosorbent assays. Univariate analysis and multiple logistic regression were performed. RESULTS: The prevalence was 30% for anti-HBc total and/or HBsAg and 7.4% for anti-HCV. There was a higher frequency of the serological markers in females and in patients aged .50 years. A significant association was detected between the presence of anti-HCV and the receipt of six or more blood transfusions. There was no association of history and number of digestive endoscopies with the serological markers analyzed. CONCLUSIONS: We observed a higher prevalence of serological markers for HBV and a lower prevalence of anti-HCV. Our results indicate that females and patients of an advanced age are the most affected categories and that patients that received multiple transfusions are at a higher probability of HCV infection.

scholarly journals Factors Associated With Low Bone Mineral Density in Adults With Type 1 Diabetes: A Cross-Sectional Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A275-A276
Author(s):  
Julie-Catherine Coll ◽  
Élodie Garceau ◽  
Laëtitia Michou ◽  
S John Weisnagel ◽  
Fabrice Mac-Way ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Z Score ◽  
Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
Factors Associated ◽  
T Score ◽  
The Past

Abstract Context: Individuals with type 1 diabetes (T1D) have a two- to threefold increase in fracture risk at any site, and up to a sevenfold increase in hip fracture risk compared to those without diabetes. The mechanisms accounting for this bone fragility are not yet fully understood. Objectives: 1) To determine factors associated with low bone mineral density (BMD) in patients with T1D; 2) To assess the association between skin advanced glycation end products (AGEs) and low BMD in patients with T1D. Methods: These are preliminary data from patients with T1D included in a cross-sectional study aiming at comparing the prevalence of vertebral fractures between adult patients with T1D from two tertiary care centers and age- and sex-matched controls without diabetes. Patients were eligible if they were aged ≥20 years and had a diagnosis of T1D for at least 5 years. Patients were classified as having a low BMD if Z-score was ≤-2.0 at any site (lumbar spine, femoral neck, total hip, radius) in patients aged <50 years or if T-score was ≤-1.0 at any site in patients aged ≥50 years or in postmenopausal women. Skin AGEs (surrogate marker of overall including bone AGEs) were measured by skin autofluorescence (AGE Reader ®). Unpaired t-tests or Chi-squared tests were used to compare characteristics between patients with or without a low BMD. Variables associated with a low BMD were determined by univariate analysis and were subsequently included in a multivariate logistic regression analysis if p<0.1 in the univariate analysis. All variables were tested for multicollinearity. Results: 106 patients with T1D were included (mean age 45.2±15.0 years; mean BMI 26.3±5.1 kg/m2; 54.7% women; mean duration of diabetes 28.2±13.6 years; 44.3% with a microvascular complication). Mean HbA1C over the past 3 years was 7.5±0.8%. A third of the patients (31.1%) had a low BMD (3 patients using Z-score; 30 patients using T-score). Patients with a low BMD were older (58.3 vs 39.3 years, p<0.001), had a lower mean HbA1C over the past 3 years (7.3% vs 7.6%, p=0.047), a longer diabetes duration (36.1 vs 24.6 years, p<0.001), higher skin AGEs (2.50 vs 2.03, p<0.001), a higher prevalence of microvascular complications (63.6% vs 37.7%, p=0.02) and a higher prevalence of abnormal albumin to creatinine ratio (ACR ≥2.0) on the day of assessment (38.7% vs 11.8%, p=0.003). In multivariate regression analysis, age (p<0.001), abnormal ACR (p=0.003) and lower mean HbA1C over the past 3 years (p=0.02) remained significantly associated with a low BMD. Skin AGEs were correlated with age (r=0.56) and diabetes duration (r=0.47). Conclusion: In this population with T1D, a low BMD was independently associated with older age, abnormal ACR and, unexpectedly, with a lower mean HbA1C over the past 3 years, but not with skin AGEs.

scholarly journals Efficacy of ultrasonography-guided sterile isotonic saline aspirate in the isolation of microorganism in the management of cellulitis

2021 ◽  
Vol 8 (7) ◽  
pp. 2073
Author(s):  
R. Prabhakar ◽  
Napa Madhusudhan
Keyword(s):  
Lower Limb ◽  
Isotonic Saline ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Gram Staining ◽  
Infected Area ◽  
Subcutaneous Tissues

Background: Cellulitis is an acute spreading infection of the skin and subcutaneous tissues characterized by local findings of tenderness, erythema, increased warmth, swelling, and regional adenopathy. Attempts to establish a precise bacteriologic diagnosis in most cases of cellulitis in adults are usually unrewarding, and therapy tends to be empiric. The aim of the study was to determine the efficacy of Ultrasonography guided sterile isotonic saline aspirate (UGSISA) in the isolation of microorganisms in the management of cellulitis.Methods: A cross-sectional study with 100 patients suffering from lower limb cellulitis was performed. The most infected area was marked with ultrasonography, using the 21 G needle under sterile precaution; around 0.5 ml of sterile isotonic saline was injected into the most infected area and aspirated. The aspirate was sent for gram staining, cultured, and analyzed according to standard procedures.Results: Needle aspirations in 100 patients were performed, and 30% had positive aspirants. The most common organism grown was Streptococci, and the least common was coagulase-negative Enterococcus, 2 patients had mixed infections. Major risk factors associated with lower limb cellulitis in our study were diabetes (54%) and spontaneous (20%).Conclusions: In our study, as a routine diagnostic procedure, needle aspiration may not be justified for all cellulitis patients, though it may still be useful in patients where the most infected area was marked with ultrasonography before needle aspiration.

scholarly journals Predictive Factors of Major Lower Extremity Amputations in Diabetic Foot Infection: A Cross-sectional Study in Three District Hospitals

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Kow Ren Yi
Keyword(s):  
Predictive Factors ◽  
Lower Limb ◽  
Diabetic Foot ◽  
Cross Sectional Study ◽  
Limb Amputation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Diabetic Foot Infection ◽  
District Hospitals ◽  
History Of

Introduction: Limb amputation in diabetic patients is associated with severe economic, social and psychological effects on patients and their families. This study aimed to evaluate the predictive factors of major lower limb amputation among patients with diabetes mellitus. Materials and Methods: This cross sectional study involved patients from a cluster of three district hospitals in Pahang, Malaysia (Hospital Kuala Lipis, Hospital Raub, and Hospital Bentong) from the 1 st September 2014 to the 31st December 2015. Age, sex, ethiniticy, facilities, presence of hypertension, duration of illness, fever, haemoglobin level, white blood cell level, urea, creatinine, history of more than three limb salvaging surgeries, diagnosis and tissue culture were assessed to determine the predictive factors of major lower limb amputation. Results: History of more than three times limb salvaging surgeries, white blood cell count more than 15x109 /L and longer duration of disease were significant predictive factors of major lower limb amputations in patients with diabetic foot infections. Conclusion: This study highlights the importance of initial limb salvaging surgeries as history of more than three times limb salvaging surgeries is a predictive factors of major amputation in diabetic foot infection.

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